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Municipal Marine Finance Application
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Step
1
of 2
Municipality Business Information :
Just 2 Sections; Information about the Municipality and Information about the Vessel being purchased.
Legal Name of Municipality/ Obligor:
*
Federal ID
Address
Address Line 1
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
County
Phone
Fax
Email
Email
Confirm Email
Gross Annual Revenue
State Organization ID
Contact Name
*
First
Last
Contact Title
Contact Phone
*
Contact Email
Email
Confirm Email
Alternate Contact
First
Last
Alternate Contact Title
Alternate Contact Phone
Alternate Contact Email
Email
Confirm Email
Type of Municipality
City
Township
State
School District
Town
County
Solid Waste District
Other
Population
Households
Department/Agency
Fiscal Officer Name
First
Last
Fiscal Officeer Title
Fiscal Officer Phone
Fiscal Officer Fax
Date Municipality Entity Was Established
Does the obligor self-insure for property & liability insurance?
Yes
No
Within the current calendar year, we or will not issue $10,000,000 or more total debt including all bonds, loans and leases.
We Will
We Will Not
Next
Vessel Information (Attach separate sheet if necessary)
Vessel Description
Boat Builder or Manufacturer
Model
Year
Quantity
Vessel Cost $
Total Cost $
Vessel Location
Address Line 1
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Vessel
Vessel is Additional
Vessel is Replacement
New
Used
Soft Costs Included?
Yes
No
Amount of soft costs included (shipping, software, and sales tax)
Buyout Included?
Yes
No
Amount of buyout included:
Describe the essential use of the vessel
Lease Terms Desired:
Length of Lease Term
3 Years
4 Years
5 Years
Other
Payment Mode
Monthly
4 Quarterly
Semi-Annual
Annual
First Payment Due
Upon Delivery
Other
Other Requests/ Requirements:
Name
Submit
