Looking for a Department Of Finance Forms And Templates? Download it for free!

Form E-501 - Formal Application For Financing Of An Energy Project For Utilities Serving The General Public Page 4

17. Does applicant anticipate the necessity of a financial feasibility study? _________ If "yes" has

the applicant selected a person or firm to provide financial feasibility consultant services for the

proposed financing? ___________ If "yes", attach copies of proposal received which should

include a description of the services to be provided and the proposed fee.

STATE OF ____________________)

: SS

COUNTY OF __________________)

Deponent, being duly sworn, deposes and says that deponent is and was at all times mentioned

in the foregoing application the authorized representative of the applicant, and being the authorized

representative mentioned in the foregoing application that the statements made in said application are

in all respects true and correct.

_____________________________

(Signature of Applicant)

Subscribed and sworn to before me this

_____ day of _______________, 19__.

_______________________________

Notary Public, _______Judicial Circuit,

State of ________________________

My commission expires: ___________

ONLY COMPLETE APPLICATIONS WILL BE ACCEPTED FOR PROCESSING BY THE

DEPARTMENT. A COMPLETED APPLICATION CONSISTS OF:

1. This form with all applicable items completed.

2. Copies of all applicable items referred to in this form.

3. Two executed copies of the fee agreement. One copy will be returned to the applicant upon

execution by the department.

4. Certified or cashier's check made out to the department in the amount of $1,000.00.

-4-

Form E-501 - Formal Application For Financing Of An Energy Project For Utilities Serving The General Public Page 4