Resolution 3925 - REPEALS RESO 3922 and Adopts Application Process for Tax Increment Assistance50
RESOLUTION NO. '.3925
A RESOLUTION REPEALING RESOLUTION NO. 3922 AND ADOPTING AN APPLICATION
PROCESS AND PROCEDURE FOR REVIEW FOR TAX INCREMENT ASSISTANCE AUTHORIZED
BY ORDINANCE #933 ON MAJOR REDEVELOPMENT PROJECTS I.N THE CITY OF
KALISPELL.
WHEREAS, Title 7, Chapter 15, Parts 42 & 43, Montana Code Annotated
authorized the City of Kalispell to develop a workable urban renewal
plan to rehabilitate and eliminate blighted areas utilizing "tax
increment finances" in partnership with private.enterprise, and
WHEREAS, the City Council of the City of Kalispell created the
Kalispell Downtown Redevelopment Plan by Ordinance #933 on September
10, 1979, and
WHEREAS, the City Council of the City of Kalispell and the Kalispell
Development Corporation have recognized the benefits to be derived
from working closely with private developers seeking to use tax increment
funds, and
WHEREAS, tax increment financing has been a successful financial
vehicle in enhancing economic development opportunities both within
and without the Kalispell Downtown'Redevelopment Plan area, and
WHEREAS, the City of Kalispell anticipates new projects from
developers wanting to participate in the tax increment program, and
WHEREAS, on May 6, 1985 the City Council of the City of Kalispell
adopted,by motion the Tax. Increment Policy Manual which set forth the
Purpose and Function of the Kalispell Development Corporation, estab-
lished a Procedure for Review of Proposals for Tax Increment Funds,
described an Application Process, contained the forms necessary to
submit a Tax Increment Financing Application, and
WHEREAS, the creation of the Tax Increment Committee of the
Kalispell Development Corporation and a review of. the Tax Increment.
Policy Manual have made it necessary to more formally adopt and amend
the Tax Increment Policy Manual, and
WHEREAS, the adoption of the Tax Increment Policy Manual as
amended by Resolution shall formally describe the purposes and processes
necessary to implement tax increment assistance under Ordinance #933.
NOW THEREFORE IT IS .HEREBY RESOLVED BY THE CITY COUNCIL OF THE CITY
OF KALISPELL:
SECTION I. That Resolution No. 3922 passed by the City
Council of the City of Kalispell on the 5th day of February,
1990 is hereby repealed.
SECTION II. That pursuant to the authority granted to the
City of Kalispell by Title 7, Chapter 15, Part 42 & 43,
Montana Code Annotated and as a means of implementing the
tax increment assistance provisions of Ordinance #933, the
City Council adopts the Tax Increment Policy Manual, as
amended, said Tax increment Policy Manual attached hereto
as Exhibit "A" and for purposes of A.his Resolution made a
part hereof.
SECTION III. This Resolution shall become effective imr„e--
diately upon passage by the City Council and approval by
the Mayor.
PASSED BY THE CITY COUNCIL OF THE CITY OF KALISPELL AND APPROVED BY
TIiE,.. MAYOR THIS 19th DAY OF MARCH ,1990.
vv� Y.
`j. `' ' ` Roger Ho ki s , 'Mayor
ATTEST : ;' ' :9+ ' ��. '. �'•' . , . "f .
Amy H,. obertson �.
Acting City Clerk -Treasurer
PURPOSE AND r
THE'KALISPELL DEVELOPMENT CORPORATION
To assist the City Council, the Kalispell Development Department
Corporation (KDC) contemplates working as closely as possible with
developers seeking.the use of tax increment funds. The KDC's primary
objective relative to assisting potential developers will be to assure
that all project proposals are complete in terms of providing all the
necessary information to allow the City Council to make a decision
regarding the proposal. Successfully performing this function should
eliminate the possibility of the City Council delaying action due to
a lack of information.
The Tax Increment Committee of the Kalispell Development Corporation
shall act as a liaison between the Kalispell Development Corporation
and the City of Kalispell. The Tax Increment Committee (TIC) shall
review all requests for expenditure of tax increment funds, proposed
development projects, and infrastructure improvements in the Downtown
Redevelopment Area. The TIC shall be composed of the Mayor of the
City of Kalispell, the Chairman of the Community Development Committee,
Kalispell Development Corporation President, Kalispell Development
+, Corporation President -Elect, Immediate Past President, and such other
members as the Kalispell Development Corporation Executive Committee
shall submit annually to the Mayor and City Council for confirmation,
who shall be appointed by the Mayor with the advise and consent of
the City Council. Decisions of the KDC/TIC shall be forwarded as
recommendations through the Community Development Department to the
City Council for action.,
The KDC's primary objective in assisting the City Council is to
prepare a sound recommendation pertaining to each project proposal's
potential for efficient use of the funds. The KDC has adopted the
following goals and priorities pertaining to the use of tax increment
funds. All project proposals will be evaluatedaccording to how well
they meet the goals and priorities.
REDEVELOPMENT GOALS
To eliminate slums .and blighting influences as well as inappropriate
land uses within the Redevelopment Area and specifically the Central
Business District, and to free land for development into more economic
uses. To establish, a pattern of land use within the Redevelopment
Area which is functional, imaginative, and achievable, and which
provides for residential, commercial, and industrial development. To
provide a system of off-street parking facilities which recognizes
the needs of the shopper, the businessman, the resident, the high
school student and the employee. To develop a traffic circulation
system within and around the Central Business District and Redevelopment
Area which provides for safe and convenient automotive and pedestrian
movement. To strengthen the Central Business District's position ,as
the retail, business, and financial center of northwest Montana.
PROJECT PRIORITIES
:The -amount of economic activities to be generated by the project, the
total employment generated by the proposed activities, the increase
and expansion of the tax base with the planned development and the
project's impact on the fiscal deterioration within the Redevelopment
District and community. Other forms of financing that will be leveraged
with .the project, the developer's past performance and the total
feasibility of the project.
Section 7-15-4288, MCA. Costs which may be paid by tax increment
financing. The tax increments may be used by the municipality to pay
the following costs of or incurred in connection with an urban renewal
.project;. --sr. - ,;„: ai41r.r
t
(1) land acgis in ;. r •. r: fi , ,,�.,. : �'
(2) demolition .ari 'removal of'structures;
(3) relocation of occupants; and
.,�the..._,acgµ s i t,i.og,.. construction,. . and improvements ,.of
stree'th cur s•, dutteks, sidewalks, pedestrian malls, alleys;
:,parking, lots;and off-street parkingf.acilities,' sewers, water-
lines, waterways, public, buildings, .and other. public
improvements authorized by parts 41 through 45 of chapter
12, Parts 42 and; ;43 of chapter'
13, end part 47 of chapter
'14 and items of* 'Personal property to be used in connection
with improvements for which the foregoing costs may be
incurred; and :.
(5) costs incurred in connection with the redevelopment
activities allowed under 7-15-4233.
Tax increment may
premiums, if any,
pursuant to state
of providing funds
and
law
to
p eage o e r yi' EMIC U:: -Vilt
interest on bonds which the. Agency may issue
for the purposes listed above for the purpose
pay such costs.
PROCEDURE FOR REVIEW OF PROPOSALS FOR TAX INCREMENT FUNDS
1. Initial contact to present a proposal for the use of
tax increment funds shall be made through the Community
Development Department. Application forms and development
criteria will be made available to developers.
Applications shall consist of a written project proposal
providing the following information:
-Name, address, etc. of the applicant.
-Location of the project.
-How much money is being requested?
-Will TIF funds be in the form of a loan?
-What is the proposed use of the funds?
-What are the requested terms of the agreement? (How long
for repayment? How will it be repaid?)
-What combination of funding will be used in the project?
-Some idea of what increase in taxes would be generated
from the project.
•-A brief history or track record of the applicant.
-Do they plan to take advantage of the tax incentives such
as the remodeling tax credit?
-Any additional items as determined by City staff or. the
KDC.
2. The Community Development staff shall submit the project
proposals to the City Council for informational purposes.
Staff will refer all proposals to the KDC for. processing.
3. KDC Action - the KDC working through the Tax Increment
Committee (TIC) will conduct meetings upon demand with proper
public notices. The KDC/TIC will provide the City Council
with copies of minutes of all meetings. City staff will
act as staff for the KDC/TIC and provide the members with
copies of project proposals prior to meetings. Groups
making proposals will be asked to limit their presentations
to approximately 20 to 30 minutes with only one speaker
participating in the actual presentation. Under no circum-
stances will the KDC/TIC consider taking action on a proposal
unless all parties involved in the proposal are present or
represented by someone with the authority to make commitments
on their behalf. The Ki:C/TIC will prepare a written recommen-
dation for consideration to the City Council. Presentation
will be made by the KDC/TIC and the proposed developer at a
work study session of the City Council. The applicant will
receive a copy of the recommendation.
4. City Council Action - The City Council, as Urban Renewal
Agency, may act upon the proposal at the regularly scheduled
a
meeting or, if it deems necessary, may schedule public
hearing to consider the proposal. At the time that the
Council considers the proposal, it will permit all interested
parties to present information pertinent to the proposal.
Any project proposal.receiving approvalbythe.City Council
"and' hrbu the use of a
should'" be c"odumented finl
_alizegh
"legally binding'_�." Development Agreement "4.. Such an agreement
will specify, in" detail, what all parties involved in the
proposal have committed 'to loan, pay, develop, etc.
APPLICATION PROCESS
TAX INCREMENT FINANCING
I. INTRODUCTION
The existence of blighted areas within the municipalities of Montana
has been identified by the state legislature as a problem which
requires government action. Enabling legislation has given local
governing bodies the authority to establish urban renewal districts,
utilize urban renewal powers, and implement urban renewal projects
through the use of tax increment financing. Tax increment financing
(TIF) is a significant element of the urban renewal law, allowing
urban renewal programs to be financed locally without reliance on
limited federal funds. The principal behind TIF is the ability of
the local governments to use the increase in taxes within a specified
district above an established base year for redevelopment projects.
In 1979 Kalispell adopted an urban renewal plan and designated the
central business district as a blighted area. Property taxes continue
to be paid to all taxing jurisdictions on the basis of the 1979
taxable valuation. Any subsequent tax increases due to new development_,
inflation, or re -appraisals, however, are set aside for the City of
Kalispell which has been delegated the authority to undertake urban
renewal efforts.. After the expiration of urban renewal authority on
1987 or after retiring of all bonded indebtedness incurred for renewal
activities, the base year restriction is eliminated and the local
taxing jurisdictions obtain the additional tax revenues generated
through redevelopment.
Tax increment financing is not an abatement program for new development.
Revenues obtained, however, may be utilized to encourage the implemen-
tation of public or private projects. As specified in state law, the
City of Kalispell may utilize TIF for the following activities:
1) land acquisition;
2) demolition and removal of structures;
3) relocation of occupants;
4) public improvements; and
5) costs .incurred in the exercise of urban renewal powers,
including urban renewal projects as authorized by Kalispell
City Council, Ordinance #933. Loans and grants may be
eligible under this provision.
II. APPLICATION PROCESS
The City Council of the City of Kalispell has the authority to assist
developers in the implementation of redevelopment projects.. The
following procedure has been developed to process TIF funding requests.
Costs to be paid with TIF monies may not be incurred by the applicant
prior to the effective date of funding approval and the satisfaction
of any conditions of such approval.
Contact the City of Kalispell__ Community Development
Department,
City of Kalispell, Kalispell, MT, to discuss
the project
and determine eligibility for TIF
assistance.
PrepareApplication-
The CD staff will assist
the developer
in preparing
a formal application.
Staff Review
- Upon submittal of all necessary
information,
the staff reviews the merits of the project
and the need
for funding.
Board Review 6 DecisiDn - ,Toe-,K•ali-spe13, Development Corpor-
ation (KDC)/Tax Increment Committee (TIC) reviews the project
and staff recommendation, and either recommends approval/
disapproval for funding request or requires more applicant
informa_tion,:
City Council Reydew,and Approval - The City•Counci1 of the
City of Kalispell., will review and make the final decision
;on the KDC/TIC recommendation on presentation by the Community
...,,Development Committee.
III. APPLICATION REQUIREMENTS
A developer must submit a written application for each proposed project.
The following information would generally be required in the application.
Based on the nature and amount of the request, the CD director may
exercise discretion in the application information requirements. In
particular, the director may waive the requirement of personal financial
statements when not deemed necessary for the evaluation of a project.
At any point in the review process, the staff or board may request
more .information of the applicant. The CD staff will assist the
developer, when necessary, in developing the information.
1. Project Description - a description of the project,
type of development and scope of work including:
- plans/schematics
- project schedule. -
completion of project
- project feasibility -
and economic feasibility
proposed timetable for
substantiate the market
of the project.
2. Pljicinclnij - d de6cripLivn 01 the financial
arrangements of the project to includes
- source of funds - detailing terms and conditions.
- I.wlldol L'4r{Hiil1 I..{Ball I tJ - UV I LIcf{{u`a uj� cullmi l l,l11a11 LU uX
funds necessary for completing the project
cost breakdown - estimated cost of project
-proforma - projections of anticipated income,
expenses, cash flow and depreciation for the first
five years of the project.
3. Development Entity - a public disclosure of the development
entity and other involved parties including information on
qualifications and past experience.
4. Financial Disclosure - full financial disclosure of
development entity with evidence that the developer has
both the financial and legal ability to complete the proposed
project. As per adopted policy, this information will be
kept confidential, subject to a challenge of this policy in
a court of law. Provide a letter from financial source.
5. [necessity of TIF - a "but for statement" that private
investment is contingent on TIP, based on cash -on -cash return
and internal rate of return.
6. Leverage Ratio - ratio of public to private investment..
7. Em to meat Generated - best estimate of construction
and permanent jobs to be generated by the project and a
Wage/salary scale for employment created.
8. Letters of intent from tenants for lease project.
9. Tax Generation - The existing tax base of the property
upon which TIP assistance is requested must be compared to
the anticipated tax base resulting from the proposed project
and must demonstrate that the increase in taxes generated
by proposed project will cover TIF° assistance over a period
of.not to exceed ten years.
The following .hypothetical development would be a realistic
guide for development using a $2 million project:
$2,000,000.00
3.86
.. - .77,2a0.00
.459425
35,467.70
_ _5,211.99
$ 30,255.61
IV. CRITERIA FOR REVIEW
Market
Assessed
Consolidated Mill
Taxes, Generated. by Proposed Project
Existing Taxes
TIP. Tax Annual Increase
The submission of an application for tax increment assistance begins
the review process which is undertaken by the Community Development
staff and the KDC/TIC. Materials contained in the application provide
information needed t.o assess the merits .of the project in relation to
the goals and objectives of the Urban Renewal Plan. This will allow
the KDC.'/TY.0 to decide between competing projects or determine if a
proposal has sufficient benefits to warrant assistance. The KDC/TIC
evaluates a project based on the following criteria.
1
I. Economic St' 1
be
_ _ imu us - The amount of economic activity to
generated by the project. This includes an earnings
statment and/or projections of annual gross sales which
result from the project.
2. Eml2loyment Generation -- Total employment generated by
the project including short-term construction and long-term
Permanent jobs. Included should be a wage/salary scale for
all employment created. Additional employment "spinoff" or
the multiplier effect is also considered.
3. Tax Generation - The estimated taxable value or a
breakdown of the praject's total construction cost must be
submitted. This will allow the City to determine additional
tax payments and the amount of assistance to be provided.
4. Elimination of Blight - The project's impact on the
physical and fiscal deterioration within the urban renewal
district and the community.
5. Financial Assistance - Other forms of financing associated
with the project including equity, lender participation,
industrial development revenue bonds, and state or federal
monies will be examined to assess the need for TIF assistance.
In addition, tax incentives under the Economic Tax Recovery
Act will be considered.
6. Developer Past Performance - The applicant's demonstrated
performance in implementing similar projects.
7: Project Feasibilty - Based upon the proforma and financial
arrangements, a review of project feasibility will be undertaken.
8. Impact Analysis/Assessment - This review will be based
on
environmental impaets,-design, and dislocation associated
with the project.
9. Special or Unique_ Opportunities - The extent to which
the
project represents a special or unique opportunity to
meet local priority needs that
are consistent with economic
revitalization and urban redevelopment objectives.
10. Timely Completion - The feasibility of accomplishing
the Project in a timely manner
(one or two years) within
the total project budget.
11. TIP Assistance - TIF assistance to a developer initiated
project shall noCexceed 10%
of the entire project including,
but not Limited to, land assemblage, acquisition, demolition,
construction,
landscaping, utility connections,
parking, etc.
Based upon this criteria, a decision will be made on the provision of
financial assistance. If approved, post approval requirements will
be undertaken.
V. POST APPROVAL REQUIREMENTS
1. Development Agreement -- The City and the developer must
sign a legally binding development agreement which finalizes
the terms and conditions of the TIF assistance.
2. Reporting Re uirements - Developer shall provide the
City with 90 day progress reports and other reports on
approved projects as specified in the development agreement.
i
EXHIBIT "A"
TAXINCREMENT POLICY MANUAL
(Procedures Necessary to Implement Tax Increment
Provisions of Ordinance #933)
._
Adopted Resolution No. 3March 19� 1990
Pursuant to 925 ,:
TAX INCREMENT FINANCING APPLICATION
CITY OF KALISPELL COMMUNITY DEVELOPMENT.DEPARTMENT
A. APPLICANT
1. Name:_—
2. Address: _
3. Contact Ferson:_
Telephone Number:—
B. Project
1. Location%.
a. address:
---_----
b. legal description:
2. Present Ownership of Site.
3. Narrative Description of Project:
4. Plans/Schematics: (attach schematics, site and
landscaping plans, and renderings, if available).-
5. Project. Schedule:
1
1
1
6. Market analysis: (attach market study or other
analysis regarding feasibility of project.)
7. Employment Generated by Project:
a. construction jobs:
b. new permanent jobs:
C. transferred jobs: _
d. retained jobs:
C. Project Financing
1. Source of Funds: (complete attached forms)
2. Lender Commitments: (attach evidence of commitment
of funds)
3. Estimated Project Costs: (complete attached form)
4. Proforma: (complete attached form)
D. Tax Increment financing (TIF) Request
1. Amount. Requested:
Pr2ject_Act.ivity
$
Total Request $
2. Necessity of TIT' Assistance: (evidence that
private development is contingent on TIT' assistance)
3. Estimated Leverage Ratio
a. total private investment
$
b. TIF request
$
C. leverage ratio
W b)
E. development Entit :
(complete "Developer's
Statement
for Public Disclosure"
form)
F. Financial Disclosure:
(complete
Financial
"Developer's Statement
Responsibility" form)
of Qualifications and
PROJECT
I. SOURCES OF FUNDS
Private Leader
$
Developer Equity
$
TIC' Request
$
Other Funds (specify)
$_ -
Total Project Cost
II. EQUITY
Cash Invested
$,
other,(specify)
$
$
Total Developer Equity
Ill. LENDER COMMITMENTS
Lender
Amount of
Loan
Interest
Payment/
Term Period
years $�
years $
1
1
1
1
1
1
Land:
Cost of Land
Off -Site Improvements
On -Site Improvements
Other Land Improvements
Total Land & Improvements
Structures:
Excavation
Foundation
Frame
Floor Structure
Floor Cover
Ceiling
Interior Construction
plumbing
Sprinklers
Beating - Cooling
Electrical
Exterior Walls
Windows
Wall Ormentation
Roof Structure
Roof Cover
Elevator
Other
Total Structure
Total Structure & Land
13
PROJECT COSTS
Fees:
Legal
$
General Requirements
$
Builder's Overhead
$
Builder's Profit
$
Appraisal
$
Architect Design &
Supervision
$
Permits
$
Other Fees
$
Total Fees
Financial:
Bonds
$
Interest During Const.
$
Taxes During Construction
$
Construction Insurance
$
Interim Financing Fee
$
Origination Fees
$
Title & Recording
$
Other
$
Total Financial
Supplemental Management Fee:
Developer Profit & Risk
$
Contingency Reserve
$
Total
Total Estimated Development Cost
1
1
1
11,
m
n
m m
a
((DD
o
Ui
UI
rr
rr
UI
O
U1 C
UI
w
UI
(n
UI (D
..
�'
..
'�
100
(D
O
3
�
r-
(D
(D
piro
n
n
a
n
O
'0
O
G
C (D
m
r•
pa
+(
r0
O
O
O
'U C
0
o
o
n
to
c
w
ro
ru
to
(D (D
O
(D
U
w CA
0
a
(D
w
w
r•
r•
(D
(D
(D
n "
G
rr
rr
*e
w
rr
r•
Cl
+ti
+
rt
r<
a rr
�:l
w
n
w
�w
(D
(D
En
rr
rr
rr
.-. � ..
�
rt
w
�
C]
w
(D
In
U)
C
' C
�C
rr Ul
P.-J
•
rr
rfi
W
t.,.
(A
to
to7
H.
'•<
O
Da
"1
(D
'A�
�
Ln
W
�3
l6
G
N
x
�
(fin
H
a
1-3
aj
m
D
�
t�
r
(D
n
El
ro
ro
w
r
r)
x
(o
(D
(D
(D
n
Q
�
O
n
(D
a
�
�
(D
n
(D
w
En
a
(D
N
m
W
w
�
m
]3
r•
(D
(D
a
rr
m
(n
r
rt
n
(D
rl
cn
(D
ul
ti
(D
irl
o
n
c
N
N
m
a
�r
..
to � {
r
DEVELOPER'S.STATEMENT OF QUALIFICATION AND FINANCIAL
RESPONSIBILITY
(For confidential official use of the City of Kalispell Community
Development Department)
1. a. Name
b. Address
2. Is the applicant a subsidiary of or affiliated with any other
corporations or any other firm or firms? _ Yes �tyo
if yes, list each such corporation or firm by name and address,
specify its relationship to the applicant, and identify the officers
and directors or trustees common to the applicant and such other
corporation or firm.
3. a. The financial condition of the applicant, as of
19 _® is reflected in the attached financial
statement.
(NOTE: Attach to this statement a certified financial statement
showing the assets and the liabilities, including contingent li.abil-
i.ties, fully itemized in accordance with accepted accounting standards
and based on a proper audit. If the date of the certified financial
statement precedes the date of this submission by more than six
months, also attach an interim balance sheet not more than 60 days
old.)
b. Name and address of the auditor or public accountant who
performed the audit on which said financial statement is based:
4. If funds for the project are to be obtained from sources other
than the developer's own funds, a sL.aLement. of Lhe developer's plan
for financing the acgi.i i si t ion and development of I he. land.
and amnII111 of cash avrailahle to developer to meet equity
require:menls of t-110 }-)l OPUS LI Ulidut L,ak illy (,I 1(_( I4�1. ul. CI t-LIi I w.iy
required to substantiate Lhe availability of developer. equity):
6. Names and addresses of lender references:
7. a. Has the applicant or any individual or entity affiliates] with
the development of this project been adjudged bankrupt, either voluntary
or involuntary, within the past 10 years?
Yes I No
If yes, give date, place, and under what name.
b. Has the applicant or any individual or entity affiliated with
the development of this project been indicted for or convicted of any
felony within the last 10 years? —_Yes No
If yes, give for each case (1) date, (2) charge, (3) place, (4)
court, and _(. ,!_ actio% taken., Attagq ,,any.expl,poni,de.emed necessary.
8. Outline undertakings, comparable to the proposed project, which
have been completed by the developer or any of the principals of the
developer, including identification and brief description of each
project and date of completion:
9. Identify the construction contractor or builder who will undertake
this project.
I
I -A
a. Name and address of such contractor or builder:
b. Has such contractor or builder within the last 10 years ever
failed to qualify as a responsible bidder; refused to enter into a
contract after an award has been made, or failed to complete a
construction or development contract? _--Yes No
If yes, explain:
c. Total amount of construction or development work performed
by such contractor or builder during the last three years:
General description of such work:
d. Construction contracts or developments now being performed
by such contractor or builder:
DATE TO BE
PROJECT LOCATION AMOUNT COMPLETED
e. Outstanding construction -contract bids of such contractor or
builder:
PROJECT
AMOUNT DATE OPENED
10. Does any member of the local governing body or the City of
Kalispell Community Development Department to which the accompanying
bid or proposal is being made, or any officer or employee of the City
of Kalispell who exercises any functions or responsibilities in
connection with the project, have any direct or indirect personal
interest in the developer or in the project? Yes No
If yes, explain.
11. The applicant may choose to attach additional statements and
other evidence of qualifications and financial responsibility.
CERTrrICATION
I (We)1 _ certify that this
developer's Statement of Qualification and financial Responsibility
and the attached evidence of the developer's qualifications and financial
responsibility, including financial statements, are true and correct
to the best of my (our) knowledge and belief.
Dated:_______,—
Signature
— Address and Zip Code --
Dated:—_ —
Signature �--
.Title -
Address and Zip Code
1If the developer is a corporation, this statement should be signed
by the President and Secretary of the corporation; if an individual,
by such individual; if partnership, by the managing partner; if an
entity not having a president and secretary, by one of its chief.
officers having knowledge of the financial status and qualifications
of the developer.
DEVELOPER'S STATEMENT FOR PUBLIC DISCLOSCIREI
A. Applicant
1. a. Name
b. Address
C. IRS Number of Applicant
2. if the applicant is not an individual doing business under
his own name, the applicant has the status indicated below and is
organized or operating under the laws of --_-__ — ----
A corporation.
A nonprofit or charitable institution or corporation.
A partnership known as
A business association or a joint venture known as
A federal, state, or local government or instrumentality
thereof.
Other (explain).
3. If the developer is not an individual or a government agency
or instrumentality, give date of organization.
4. Names, addresses, title of position (if any), and nature and
extent of the interest of the officers and principal members, share-
holders, and investors of the applicant, other than a government
agency or instrumentality, are set forth as follows;
a. If the developer is a corporation, the officers, directors
or trustees, and each stockholder owning more than 10% of
any class of stock.
b. If the developer is a nonprofit or charitable institution
or corporation, the members who constitute the board of
trustees or board of directors or similar governing body.
C. if the developer is a partnership, each partner, whether
a general or limited partner, and either the percent of
interest or a description of the character and extent of
interest.
lif space on this form is inadequate for any requested information,
it should be furnished on an attached page which is referred to under
the appropriate numbered item on the form. -- -
d. If the developer is a business association or a joint
venture, each participant and either the percent of interest
or a description of the character and extent of interest.
e. If the developer is some other entity, the officers,
the members of the governing body, and each person having
an interest of more than 1.0%.
DESCRIPTION OF CHARACTER AND
NAME, ADDRESS AND ZIP -CODE EXTENT OF INTEREST
5. Name, address, and nature and extent of interest of each
person or entity (not named in response to Item 5) who has a beneficial
interest in any of the shareholders or investors named in response to
Item 5 which gives such person or entity more than a computed 1.0%
interest in the developer (for example, more than 20% of the stock in
a corporation which holds 50% of the stock of the developer, or more
than 50% of the stock in a corporation which holds 20% of the stock
of the developer):
1
1
NAME, ADDRESS, AND ZIP CODE
DESCRIPTION OF CHARACTER AND
EXTENT OF INTEREST
1
C
6. Names (if not given above)
trustees of any corporation or firm
above:
of officers
listed under
CERTIFICATION
and directors or
Item 5 or Item 6
I (we) 1Dis
certify that this DeveYoofrmy (our) knowledgeuandCbeliefosure is true
and correct to the bey
Dated:
signature —
-- T i t 1 e —--��—
Address and Zip Code
Dated: — —
�.___-------
—� Signature
—�� — Title
Address and Zip Code
lif the developer is an individual, this statement should be signed
by such individual; if a partnership, by
one of if a
corporation or other entity, by one of its chief offic)ers having
knowledge of the facts required by this statement.