Black Economic Development Fund Investment Intake Form
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Section 1 (of 5)
Legal Name of the Borrower:
Name of the Sponsor or Guarantor (if different from the Borrower)
Organization Type
Nonprofit
For-profit
Limited Partnership
General Partnership
LLC
Individual
Other
Address of the Borrower
Primary Contact Name
Primary Contact Email
Primary Contact Phone Number
Section 2 (of 5) - General Project Information
Loan Type
Predevelopment
Acquisition
Construction
Bridge
Project Type
Affordable Housing
Market Rate Housing
Senior Housing
Mixed Use
Retail
Office
Warehouse
Commercial Business
Deposit (Minority Deposit Institutions Only)
Other
Requested Loan Amount
Minimum Loan Amount is $1,000,000. Maximum Loan Amount is $10,000,000
Requested Loan Term
Indicate if months or years
Requested Amortization
Estimated Total Development Costs
Describe Use of Proceeds
Total Units (if applicable)
Total Square Feet
Repayment Event and Source
Repayment Committed
yes
no
Date that Financing is Needed By
Site Control Status
Borrower owns
Under purchase agreement
Under lease agreement
To-be acquired
Other
Section 3 (of 5) - Sponsor Overview
Sponsor Overview (please describe)
Year Formed
List of Principals (name and key background information - CEO, CFO, ED, etc)
List the Development Team (developer, general contractor, architect, property manager, consultant(s))
Section 4 (of 5)
Project Name
Project Address
Executive Summary
Section 5 (of 5) - Attachments
Proforma
Development budget
Projected sources and uses
Unit mix (number of units, unit type, affordability restrictions if applicable)
Commercial projects (description of tenant, status of lease, and pertinent lease information)
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