Testing - Saint Paul Port Authority

Lease Application

Step 1 of 6

16%

Application for Equipment Financing

Legal Name of Lessee (Applicant)(Required)

Tax ID #(Required)

Web address (if, applicable)

Address(Required)

City(Required)

State(Required)

Zip(Required)

Contact(s) Regarding Project

Name(Required)

Title(Required)

Phone(Required)

Email(Required)

Name

Title

Phone

Obligations/Economics

Are the Applicant's obligation bank-qualified (i.e., expected to issue less than $10 Million in tax-exempt financing this calendar year)?

Please select the Applicant's current underlying bond rating from the rating agencies listed below (if applicable)

Moody’s Investor Service

Standard & Poor’s

Fitch

Moody's Investors Service:

Standard & Poor's:

Fitch:

Discuss the Applicant's economic trends (stable, positive, negative) and reasons for any variation

Has the Applicant ever defaulted or non-appropriated on an obligation?

Please explain

Demographic Information

Please provide the following demographic information (Please attach any applicable demographic statistics)

Approx square mile

Cities, Towns and Counties

Population

Increasing or Decreasing Population?

please explain

Educational Applicants Only

Enrollment

Please also answer the above question regarding the resident city

Increasing or Decreasing Enrollment?

Please explain

Elementary:

Middle:

High School:

Other:

How many schools make up the district (please list the number and type of each school)?

Purchase Description (Please be specific and attach any applicable equipment lists of invoices available)(Required)

File

Max. file size: 64 MB.

Est. Equipment Delivery Date(Required)

MM slash DD slash YYYY

Is the Equipment replacing existing equipment?(Required)

Please state how long you have currently used the Equipment and the reason you are replacing the Equipment(Required)

Please state the reason additional equipment is needed(Required)

What will the Applicant do with the old equipment that is being replaced?(Required)

Please describe in detail the following (please be specific)

What will the Equipment be used for?(Required)

Describe the essential nature of the equipment financed(Required)

List the specific department that will be the primary user of the Equipment(Required)

Lease Payments

Will the lease payments be made from Applicant's General Fund?(Required)

If No, from which Special Fund will the lease payments be made?(Required)

Will any federal grant or loan monies be used?(Required)

Please describe(Required)

Has the first payment been appropriated?(Required)

Terms and Conditions

Total Cost of Equipment

Advance payment

Amount to Finance

Term (in years)(Required)

Frequency (choose one):

Remittance (choose one):

Equipment Delivery Date

MM slash DD slash YYYY

Insurance Company Name or indicate Self Insured

Amount of Liability Insurance

Amount of Property Damage Insurance

The undersigned hereby certifies that all the information in the above Application for Equipment Lease and Essential Use Form is true, complete and correct.

Title(Required)

Date(Required)

MM slash DD slash YYYY

Lease Application

Application for Equipment Financing

Contact(s) Regarding Project

Obligations/Economics

Demographic Information

Educational Applicants Only

Please describe in detail the following (please be specific)

Lease Payments

Terms and Conditions

The undersigned hereby certifies that all the information in the above Application for Equipment Lease and Essential Use Form is true, complete and correct.

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