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and address of former owner: <br />int of down payment: <br />currently holds the mortgage - <br />i of mortgage: <br />Of interest on mortgage: _ <br />monthly payment at which the <br />act for deed is being liquidated: <br />Purchase price: <br />Amount of Contract for Deed: <br />and address: Who currently holds contract for deed - name and address: <br />and/or <br />Terms of'Contract for Deed: _ <br />Rate of interest on Contract for Deed: <br />Are the payments on the mortgage and/or contract for deed <br />up to date? Yes No <br />the amount of the investment that the applicant has in the business premises, fixtures, furniture, stock in trade, etc. <br />;h supporting proof of the sourcelof such money) <br />the full names, date -of -birth, addilesses, telephone numbers of all persons, other than the applicant, who have any <br />ficial interest in the business, buildrigs, premises, fixtures, furniture, or stock in trade. State the nature of the interest <br />int (This shall include, but not be limited to, any <br />t thereof, and die terms for pay hent for or other reimbursemenes, lessors, mortgagors, lenders, I en holders, trustees, trustors and persons who have co-signed notes or otherwise <br />A, pledged, or extended security or ally indebtedness of the applicant.) A release form is necessary for all persons <br />have financial interest in the bush rets_ <br />Name:: <br />e <br />-ess: <br />ie number: <br />re of interest, etc. <br />Name:: <br />First <br />Cu <br />CSS: <br />ie number <br />work: <br />re of interest, etc. <br />Name:: <br />First <br />—'— <br />ie number <br />work <br />re of interest, etc <br />Middle <br />k^- i ti 5i, f "-Irl o <br />Middle Last <br />DOB <br />-'°o <br />Ga <br />Innis Application is for premises e titer planted or carder construction or undergoing substantial alteration, the <br />a n lication shall be accompanied It a set of preliminary plans showing the design of the proposed premises to be <br />Iic used. <br />3 <br />