ࡱ> KMJ Qbjbj %2jj}l 8 <V )h~    ((((((($* -b(i;;;(  P);(  (;(JI#:9(,h( r J cde( (f)0)o(R-8-(Borrower Information Name of borrower:  FORMTEXT       SSN or TIN:  FORMTEXT       Address:  FORMTEXT       Phone:  FORMTEXT       Fax:  FORMTEXT       Email:  FORMTEXT       If borrower is an entity, please indicate type:  FORMCHECKBOX  Sole proprietor  FORMCHECKBOX  Partnership  FORMCHECKBOX  Corporation  FORMCHECKBOX  LLC  FORMCHECKBOX  Other:  FORMTEXT       For an entity borrower, please include the names and titles of the principals of the business (officers, partners, members, etc.)  FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT       County:  FORMDROPDOWN  Conservation District:  FORMDROPDOWN  Equipment Summary Type of equipment to be purchased:  FORMTEXT       General crop rotation or service provided by new equipment:  FORMTEXT       Is this your first purchase of conservation tillage equipment?  FORMCHECKBOX  Yes  FORMCHECKBOX  No Number of acres to be farmed with the new equipment:  FORMTEXT       FSA Farm Number(s) for those acres:  FORMTEXT       Equipment dealer or other seller:  FORMTEXT       Total purchase price: $ FORMTEXT       Loan amount: $ FORMTEXT       (maximum 75% of purchase price) Primary lender:  FORMTEXT       Lender phone:  FORMTEXT         Describe current farming operations:  FORMTEXT       Describe in detail the type of equipment to be purchased:  FORMTEXT       Describe in detail how the new equipment will be used to implement conservation tillage or residue management operations:  FORMTEXT       Page  PAGE 2 of 2 Applicant s Signature Date Applicant will be required to provide additional details prior to final loan approval: Letter from primary lender concerning the impact of the loan on applicants cash flow. Invoice from equipment dealer or other seller indicating the make, model, serial number and purchase price of the equipment. Final loan contract. Additional details on these requirements will be provided by the loan administrator following review of this application. Conservation District Loan Application Program administered by the Spokane County Conservation District Please complete all information and email to the address provided, or print, sign, and mail or fax to Spokane County Conservation District 210 North Havana, Spokane, WA 99202 Fax: (509) 535-7410 Email: ty-meyer@sccd.org Questions? Call Ty Meyer at (509) 535-7274 Farming Operation Details Applicants signature is not required if form is submitted via e-mail. Low-interest loans to help producers purchase the equipment necessary for: making the transition from conventional to conservation tillage or direct seeding systems implementing alternatives to field burning. For Conservation District use only. Loans for more than $100,000.00 and portfolios more than $300,000.00 require approval by the Chair of the Board of Supervisors for the Spokane County Conservation District. 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