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2. Name of Applicant
3. Email Address
5. Mailing Address
7. City
8. State
9. Zip Code
11. Phone Number
12. Number of Years in Operation
14. Name of Business:
16. Business Location Address
18. Business Structure
    -- Select One --CorporationPartnershipSole ProprietorshipLLC
19. Federal Tax ID#
21. FINANCIAL INFORMATION
23. Loan funds to be used for:

    1. Operating Capital (Working Capital)

    1. New Machinery & Equipment

    1. New Building Construction or Renovation
25. Loan amount Requested:
27. Total Project Cost:
29. Funding Sources
    List other public/private financing sources to be involved in the project. Applicant must provide minimum 10% equity. Attach any funding commitment letters or letters of intent from each source of financing indicated.
31. Financial Need
    Please provide an explanation of why FVEDC is being requested. Please provide supporting documentation as applicable.
33. If Start-Up Business, please attach the following documents

    1. Detailed budget of start‐up cost, first year operating expenses, and 3 to 5 years pro‐ forma cost/revenue projections.
    2. Personal or business financial statements.
    3. Documentation of real property that will be used for collateral, any outstanding liens and tax values.
    4. Personal credit report
35. Upload documents here:
37. PROJECT INFORMATION
39. Project Description
    Describe the type of services, technology or manufacturing businesses that is being proposed.
41. Estimated annual sales/revenue projects?
43. Major customers
44. Major Competitors
46. Project's benefit to the community
    Describe how this project will benefit the citizens and business community of Fuquay-Varina.
48. JOBS & EMPLOYMENT INFORMATION
50. (Current Employment)
52. Number of existing full-time jobs at project location
53. Number of part-time jobs at existing project location
55. Average annual full-time wage/salary
56. Average annual part-time wage/salary
58. (New Employment)
    As a result of the project
60. Number of NEW jobs project will create
61. Number of NEW part-time jobs project will create
63. NEW Jobs - Average annual full-time wage/salary
64. New Jobs - Average annual part-time wage
66. Job descriptions/classifications associated with project
    (manufacturing, administrative, executive, technical, etc.)
68. Employee Benefits

    Will your company offer new employees benefits

    1. Yes

    1. No
70. PROJECT (SITE) LOCATION
72. Construction Type

    1. New build construction

    1. Rehabilitation of existing property/structure
74. Lease or Own Property

    1. Lease
    2. Own
75. If lease, how many years
77. Building - Square Feet
    (if applicable)
78. Site Acreage
    (if applicable)
80. Application Certification - Submit Application
    By submitting this Application, the applicant certifies that they are authorized to execute the application for the business named within this application and that the information in this application and any other documents submitted in connection with the application are true, correct and complete. Upon submitting your application, you will be contacted to discuss your request for funding in more detail.
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82. Submit

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