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EMPLOYMENT AND <br /> ECONOMIC DEVELOPMENT <br /> MINNESOTA INVESTMENT FUND STATE FUNDED RLF <br /> REQUEST FOR ONE-TIME EXCEPTION <br /> The 2017 Legislature passed legislation that allows cities, counties and townships that have revolving <br /> loan funds(RLFs)seeded by state-funded Minnesota Investment Fund loan repayments may use 8o <br /> percent of the uncommitted balance for any lawful purpose if 20 percent of the balance is returned to <br /> the State of Minnesota.To utilize this one-time exception,this form must be completed and submitted <br /> to DEED by June 1, 2o18; once DEED approves the form,the 8o percent should be moved from the RLF <br /> account and the 20 percent should be transferred to DEED. <br /> Please complete this form including the requested documentation.All forms must be signed by an <br /> authorized local official. <br /> Request Date Uncommitted State Funded <br /> MIF RLF Cash Balance as of <br /> Request Date <br /> Local Government 20%to be returned to the <br /> (City,county or town) State General Fund <br /> Address 8o%to be utilized as <br /> general purpose aid. <br /> Contact Phone& Will there be a residual RLF <br /> Email balance (from outstanding <br /> loans)for future reporting? <br /> *Request must be received by June 15t, 2o18 to allow for processing and payment submittal. <br /> Required Documentation <br /> A copy of the account statement verifying the account balance as of the request date must be <br /> submitted with this form. Please note: page two of this application must be signed.A DEED Loan <br /> Officer may contact you to verify balance information for your account and review MIF award history. <br /> Submittal Instructions <br /> This form and the required bank account verification document(s) must be emailed to <br /> DEED.Loan(@state.mn.us with"Revolving Loan Fund"on the subject line. If you have <br /> questions while completing the form please contact Lisa Dargis, DEED Loan Officer, Office of Business <br /> Finance at 651-259-7446 or lisa.dargis(a)state.mn.us or visit the Frequently Asked Questions tab <br /> located at https://mn.gov/deed/business/financing-business/deed-programs/mif/mif-exception/. <br /> Rev.8/2/17 Page I 1 <br />