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APPLICATION FOR MACON-BIBB COUNTY INDUSTRIAL AUTHORITY FINANCING (Inducement Resolution Stage) 1. Individual(s) and/or Legal Entity Applying for Financing:

Name(s)______________________________________________________________________________________ Address_______________________________________________________________________________________

Telephone_____________________________________________________________________________________

2. Street Address of Project:_________________________________________________________________________ 3. Plat Attached: _____ Yes _____No 4. Project Complies with Zoning Requirements: _____ Yes _____No 5. Current Zoning Classification:_____________________________________________________________________ 6. Site Acreage:____________________ Square Footage of Improvements____________________ 7. Project’s Impact on Jobs Created or Preserved: Number at start-up _____ Number within 18 months _____ 8. Type of Business:

_____ Manufacturing _____ Warehouse/Distribution _____ Commercial _____ Other

9. Anticipated Service Area:_________________________________________________________________________ 10. Acquisition Cost: $_______________ Improvements/Rehabilitation Cost: $____________________ 11. Has any financial institution been contacted concerning Industrial Authority bonds or notes? _____ Yes _____ No 12. Lender:

Name of Lender:_______________________________________________________________ Address:__________________________________________________________________________

Contact Person__________________________________Telephone_______________________

13. Lender’s Letter of Intent Attached: _____ Yes _____ No 14. Prospective Users of the Project:_______________________________________________________________________ 15. Bank Reference(s):

Name of Bank:_________________________________________________________________ Address:_____________________________________________________________________ Contact Person:________________________________Telephone_______________________ 16. Three (3) Years of Financial Statements (preferably audited) are attached. 17. Certificate of Good Standing is attached.

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APPLICATION FOR MACON-BIBB COUNTY INDUSTRIAL AUTHORITY FINANCING (Inducement Resolution Stage) 18. I.R.S. Favorable Determination Letter (if applicable) is attached. 19. Registration Certificate (if applicable – i.e., if donation level is exceeded) from State Division of Securities and Business is

attached. 20. Application Fee of $1000.00 is attached: _____ Yes _____ No * Fee will be credited towards administrative fee upon inducement. Certification:

I certify the above information to be true and correct to the best of my knowledge this _____ day of ____________, 20___.

___________________________________________ Applicant’s Signature