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City of Lino Lakes, Minnesota <br />Vill. APPLICATION FOR FINANCIAL ASSISTANCETAv AQATCMCAIT <br />A. Applicant Information <br />Name of Corporation/Partnership <br />Address <br />Primary Contact <br />Address <br />Phone <br />Fax <br />Email <br />On a separate sheet, please provide the following: <br />• Brief description of the corporation/partnership's business, including history, principal <br />product or service, etc... Attach as Exhibit A. <br />• Brief description of the proposed project. Attach as Exhibit B. <br />• List names of officers and shareholders/partners with more than five percent (5%) <br />interest in the corporation/partnership. Attach as Exhibit C. <br />• A but -for analysis and narrative. Attach as Exhibit D. <br />Attorney Name <br />Address <br />Phone <br />Accountant Name <br />Address <br />Phone <br />Contractor Name <br />Address <br />Phone <br />Engineer Name <br />Address <br />Phone <br />Architect Name <br />Address <br />Phone <br />Fax <br />Fax <br />Fax <br />Fax <br />Fax <br />Email <br />Email <br />Email <br />Email <br />Email <br />Financial Assistance Application Page 6 <br />