Laserfiche WebLink
For questions 35 -39: Provide the following information for each recipient failing to fulfill goals or any other terms of an agreement that were <br />to be attained by the time of reporting. (Attach additional oaees if necessary. <br />35. Information on recipient and agreement: <br />Name of recipient in default Type of subsidy or assistance Initial value of subsidy or assistance <br />Street address of recipient City /Zip code of recipient Outstanding value of subsidy <br />or assistance <br />36. Reason(s) for default (Mark all that apply.): <br />❑ recipient ceased operation C] recipient relocated to a different community <br />❑ recipient was unable to fill vacant positions 0 other (Specify reason.) <br />37. To date, has the recipient fulfilled its repayment obligation? (Mark one.) <br />❑ Yes ❑ No, recipient has begun to repay the assistance. ❑ No, recipient has not be2un to repay the assistance. <br />38. Has the agreement been amended to extend the recipient's deadline for fulfilling its obligations? (Mark one.) <br />D Yes ❑ No <br />39. Describe the steps being taken to bring recipient into compliance or recoup the subsidy: <br />Return your completed MBAF(s) by April 1, 2007 <br />EITHER <br />Mail To: <br />Minnesota Business Assistance Report <br />Minnesota Department of Employment and Economic Development — Analysis and Evaluation <br />181 National Bank Building <br />332 Minnesota Street, Suite E200 <br />St. Paul, Minnesota 55101 -1351 <br />OR <br />Fax To: <br />(651) 215 -3841 <br />(Next year, please use the online version of this form. It can be found at <br />www.deed.state.mn.us/Community/subsidies/MBAFForm.htm.) <br />Minnesota Business Assistance Form (12/19/06) <br />Page 7 of 7 <br />- 4 5 - <br />Dept. of Employment and Economic Development <br />