Welcome to Scribd, the world's digital library. Read, publish, and share books and documents. See more
Download
Standard view
Full view
of .
Save to My Library
Look up keyword
Like this
1Activity
0 of .
Results for:
No results containing your search query
P. 1
Piedmont Application

Piedmont Application

Ratings: (0)|Views: 8 |Likes:
Published by NC Policy Watch

More info:

Published by: NC Policy Watch on Jul 29, 2011
Copyright:Attribution Non-commercial

Availability:

Read on Scribd mobile: iPhone, iPad and Android.
download as PDF, TXT or read online from Scribd
See more
See less

07/29/2011

pdf

text

original

 
FROI1-:ECDC
FAXNO.
2525238880Sep.30200302:35PMP2
FormRD4274·1(Rev.7-99)UNITEDSTATES
DEPARTMENT
OF
AGRrCUL
TURERURALBUSlNESS~COOPERATlVESERVICE(RBS)
FORM
APPROVED
OMBNO.0570·0011
APPLICAnONFORLOAN
(IntermediaryRelendingProgram)
Generallnformation:The"ApplicationforLoan"is
to
provideinformationneededfor
the
analysis
andloan
determinationprocess.ForcompleteguidanceseeRDInstruction4274·D.InstructionstoIntermediary
(applicant):
CompleteitemsIthrough15.Submitoriginalofthisapplicationandallsupporting
documents
to
theUSDA,RuralDevelopment.Ifadditional
space
isrequired,provideforbyanattachment.Additional
information
may
beobtained
from[heRBSNational
Office.1.
NAM:E~
(Showofficialnamewithoutabbreviationsunlesstheabbreviationisapartoftheofficialname.)
PiedmontDevelopmentcompany,Inc.
Street
2312
CityCounty
Road
KinstonLenoir
State
zrp
Code
Tp.lenhoneNumber
AmountofLoan
Required
NC
28504
(252)523-
7700
,$:1....,.000(000.00
2.APPLICANT'STAXIDENTIFICATIONNlJMBER3.D.A.TEESTABLlSHED:
~~~~~~~~~~~~~__~-L__
~0~9~__-~~~2003
ZENSHIP"If
not
apub]ic
body,
whatpercentofthe
membersor
what
percent
of
the
ownership
ofthe'intermediaryare
citizensoftheUnitedStatesorresideintheUnitedStatesafterbeinglegallyadmittedforpermanent
residence.
nonprOfit
corporation;noownership,allBoardmembers
are
US
citizens
5.HISTORYOFINTERMEDJARY:
Provideabriefdescriptionandhistoryoftheapplicant.Includerecentexperienceinmaking
andservicingcommercialloans.
SeeAttached
.Ikcor&iinK(()
th~
Paperwork
R~.d"cli(>"Aclof1995.
M
pereons
are>'e(jJI./l'tdt!re$p~"d
It)
0
c,;IJutti(1n
dilrfvfJ~"rioll
unlossitdl~pIQ?tavaltdOMSctlnlrr'JI
number.
The
V(1/,d
OMB
contro!numberfor,hisilI/armorjoncqlllUlilmis
0570'()Oll,
Th$
ume
h!/{uJredto
camplt!:/~
II,b'
i4ormori,,,,,i,r
~$limatcd
10
;:varage
$6
hoursper
response,
ihdwiinf(
rhe
liMe/PI"
,."vi~"'il1g
iI1SlrltC#oilS,
,Ha,dl)lI~
ex;sllflZ
date
sources,~alht"Jnp.andmail(lQjtJin~IheJOla
Jrltt:.Jt:J.
and
t<tJ-lttplr.lhIK(llldrc",jtWljn~
'lit
eottecnon
of
tntormaua»,
 
FROM>:ECDC
FAXNO.
252
5238880Sep.30200302:35PMP3
2
6.UTICAnON~
List
details
of
any
pending
orfinal
disciplinary
orlegal
(civilorcriminal)
actionagainsttheintermediary,members
and
directors.
NoLitigationPending
7.NAMESOFATTORNEYS,ACCOUNTANTS,ANDOTHERPARTIES-
List
thenames
of
allattorneys,accountants,appraisers,packagers,agents,andallotherparties
(whetherindividuals,partnership,associations)
engaged
by
oronbehalfof
theintermediary
(whetheronasalary,retainerorfeebas
is
andregardlessoftheamountofcompensation)
forthepurposeofrendering
professional
or
otherservicesof
any
naturewhatevertotheintermediary,inconnectionwirhthepreparation
or
presentationofthis
application.
Listallfees
or
otherchargesorcompensationpaid
OTtO
bepaidforany
purpose
inconnection
with
thisapplicationordisbursementofthe
loan
whetherinmoneyor
otherproperty
ofanykindwhatever,
by
orfortheaccountofweintennedlarytogether
with
adescriptionofsuchservicesrenderedortoberenderedwithcompletejustificationforsuchpurposes.
NotApplicable
NameandAddress
(IncludeZIPCode)
DescriptionofServiceRendered
or
to
be
Rendered
with
Complete
JustificationTotalCompensation
Agreed
tobePaid"
Compensation
AlreadyPaid
"EmerspecificdollaramOlOIr$orhourlyrates"Unknown."
"Undetermined,
"orotherimprecise.termsarenotsufficient.
8.SUBSLDIARlESAND
AFFILIATES-
(1.)
Listthenameandaddresses
ofallentitiesthatare
subsidiaries,
parent
organizations,oraffiliatesof
the
applicant.Commentbriefly
on(herelationshipbetweenthe
intermediary
andthelistedentities.
NotApplicable
 
FROMECDC
FAXNO.
2525238880
Sep.30200302:36PMP4
9.PURCHASEAND
SALES
RELATIONSWITHOTHERS·Doestheintermediaryloanto,buyfrom,selltoOrusetheservices
ofanybusinessororganizationinwhichanofficer.director,ormemberoftheintermediaryhasasubstantialinterest?
Yes[]No~
If"Yes,"
give
namesof
such
officer,
director,ormember,namesofthebusinessororganizationand
explainthenature
ofthe
transaction(s).
10.RECENERSHIP~
BANKRUPTCY·
Hastheintermediaryoraffiliateoranyofficer
or
director
of
theintermediary
or
affiliate
everbeen
in
receivershiporadjudicatedbankrupt?
o
Yes~N;o.
Tf"Yes,"givenames,
dates
and
details.
11.DISCLOSURE
OF
SPECIAL
fNFORMATION
REGARDINGPRINCIPALS
-List
belowthenamesofanyRBSemployees
who
naveany
present
orhave
had
past,directorindirect,financialinterestinorassociationwiththeintermediary,oranyofits
officers,directorsormembers.
When
amember,
officer,
ordirector,ortheirspouseisan
employee
oftheU.S.
Government,
including
membersofthearmed
forces,
detailedinformation
mustbesubmitted
withtheapplication.
NAMEAND
ADDRESS
(IncludingZIPCode)
Details
ofRelationshipor
Interest
NotApplicable

You're Reading a Free Preview

Download
/*********** DO NOT ALTER ANYTHING BELOW THIS LINE ! ************/ var s_code=s.t();if(s_code)document.write(s_code)//-->