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<br /> Bank Loan __________ $_________ <br /> <br /> Other Private Funds __________ $_________ <br /> Applicant Contribution $_________ <br /> Other __________ $_________ <br /> Fed Grant/Loan __________ $_________ <br /> State Grant/Loan __________ $_________ <br /> HRA Blighted $ <br /> Properties Forgivable Loan Program <br /> Tax Increment Financing $ <br /> Tax Abatement $ <br />Total Financing $_________ <br /> <br />Collateral Assignments <br />Lien <br /> Description of Collateral Position <br />To Bank 1 <br />To Bank 2 <br />To Private Sources <br />To Other Sources <br />To State <br />To HRA Micro Loan <br />HRA Blighted Properties Forgivable Loan <br /> <br />Value of Collateral <br /> <br /> Book Value Cost Existing Liens <br /> <br /> Land $_________ $___________ $__________ <br /> Buildings $_________ $___________ $__________ <br /> Machinery & Equip. $_________ $___________ $__________ <br />Blighted Properties Forgivable Loan Fund Application <br />Page 11of 15 <br />DRAFT <br /> <br />