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City of Pine City <br />315 Main St S. Suite 100 <br />Pine City, MN 55063 <br />320-629-2575 <br />COVID-19 Emergency Relief Loan Application <br />Business Information <br />Legal Business Name: State Tax ID: <br />Federal EIN: <br />Individual Corporation Partnership LLC Other - <br />Physical Address: City State Zip <br />Mailing Address: City State Zip <br />How long has this business been in operation? <br />Business Owner(s) Information <br />Are you the owner of the building/property where your business is located? Yes No <br />How long have you owned / operated this business? <br />Owner 1 Full Name: Social Security #: <br />Address: City State Zip <br />Work Phone: Home Phone: Cell Phone: <br />Owner 2 Full Name: Social Security #: <br />Address: City State Zip <br />Work Phone: Home Phone: Cell Phone: <br />If there are more than 2 owners please attach an additional sheet. <br />Statement / Details regarding need and use of funds <br />(you may attach a detailed description to your application if needed) <br />Amount Requested <br />$ <br />The foregoing information is submitted in order to obtain loan funds through the City of Pine City’s COVID-19 Emergency Relief Loan Fund <br />and is true and correct. I understand that the loan will be administered through the City of Pine City and agree to make my payments to the <br />City. I hereby agree to abide by all of the terms and guidelines of which I am familiar. <br />Signature: Date: <br />Signature: Date: <br />FOR OFFICE USE ONLY <br />Received by City ____________________________ <br />Approved by EDA ____________________________ <br />Loan Effective ____________________________ <br />Amount Requested ____________________________