Clarence Campeau Development Fund
APPLICATION FOR EQUITY CONTRIBUTION
Name of Applicant:
Trade Name of Business:
Your Business is:
̈A Proprietorship ¨ A Partnership ¨ An Incorporated Company
Business Phone No.:
What Type of Business Is This:
Mailing Address: City/Town Postal Code
Amount Being Applied
For:
$
Reason You Are Applying For This Contribution:
BELOW PLEASE INDICATE WHAT YOUR PROJECT COSTS WILL BE AND THE AMOUNT OF
FINANCING REQUIRED
PROJECT COSTS:
FINANCING:
Land and Buildings
$
CCDF
$
Machinery & Equipment
Bank/Credit Union
Vehicles
Cash Equity
Leasehold Improvements
Other (specify)
Working Capital
Administration Fee
(1% of Contribution Request)
Other (specify)
TOTAL
$
=
TOTAL
$
Names of Owners of the Business: Position Held: % Owned MNS Membership No.
(Attach copy of Membership
Card to Application Form)
Name of Your Business's Bank:
Branch Address:
Phone Number:
Existing Limit on Operating Line of Credit: $
OUTLINE EXISTING BUSINESS LOANS:
Name of Lender
Original Amount
$
Due Date
Present Amount Due
$
Interest Rate
%
Repayment Terms
Security Given
Name of Lender
Original Amount
$
Due Date
Present Amount Due
$
Interest Rate
%
Repayment Terms
Security Given
ADMINISTRATION FEE:
The Fund will be charging an administration fee 1% of the approved contribution to cover the initial expense
for preparation and security documentation.
CREDIT INFORMATION:
The Ap