Montana Department of Environmental Quality
Alternative Energy Revolving Loan Program
1520 E. 6th Avenue
PO Box 200901
Helena, MT 59620-0901
406-841-5200
Please attach the following:
√
Include three most recent pay stubs for each applicant OR most recent tax return, if self-employed or a
business.
√ Attach any useful brochures or manufacturer’s data and any dealer or contractor bids
√ Non-refundable application fee of $50 for individual or $100 for joint or business applications. Checks should
be payable to Montana Department of Environmental Quality (DEQ).
Loan Request:
Amount $ ______________________
How did you hear about this loan program? ______________________________________________________________
Applicant: (A) __________________________ Co-Applicant: (B) _________________________________________
*SS# (A) ________________________________
*SS# (B) _________________________________________
Mailing Address __________________________________________ City/State/Zip ____________________________
How Long? ______________
Location of Project ______________________________________________
City __________________________
Telephone (Work) _____________________ (Home) _____________________E-Mail __________________________
Applicant & Co-Applicant Income (for previous 12 months): Attach additional pages if necessary
Applicant: Employer_______________________________________ Phone__________________________
Time with Employer ______________ Position___________________ Monthly Salary $__________
Co-Applicant: Employer __________________________________ Phone ___________________________
Time with Employer______________ Position ___________________ Monthly Salary $__________
If you are self-employed or if your income does not come from a regular salary, attach copies of your most recent tax
return. We will contact you if we need more information.
Please be as complete as possible.
Assets
Liabilities
Bank Account
$
Financial In