National Trust Loan Fund Inquiry

THIS IS NOT AN APPLICATION FOR FUNDING. Please fill out this form completely in order to help the National Trust Loan Funds (NTLF) staff serve you better. The information provided on this form will be used only for processing a preliminary Loan Funds inquiry and will not be shared with anyone outside of the National Trust for Historic Preservation without permission.

Thank you for your inquiry.

A. NAME AND CONTACT INFORMATION
If any of the fields do not apply, please type N/A

Organization

Contact Name

Mailing Address

(Maximum response 255 chars, approx. 5 rows of text)

Phone

Fax

Email Address

Web Address

How did you hear about the National Trust Loan Funds?

B. How Can We Assist You?

If you would like to receive Loan Funds information via email without providing information about your project, please skip section C and proceed to the bottom of the page and click "Submit".

If you have a project that you would like NTLF staff to consider for funding, please complete Section C below. Eligible projects will be invited to submit an application. An invitation to submit an application is extended at the sole discretion of NTLF staff and does not constitute a commitment to fund the project. Incomplete Information Request Forms will not be considered, however all inquiries will receive a response from an NTLF staff member.

C. PROJECT DESCRIPTION:

Please provide a brief description of the project and/or property for which you are seeking funding. Include total development costs, prior, current and/or future use of property, current condition of property and any other relevant information:

Address of subject property, including zip code:

(Maximum response 255 chars, approx. 5 rows of text)

Requested loan amount ($)

Proposed use of loan funds

Proposed collateral (include value, if known - indicate whether value is "as is" or "post-rehabilitation" and source of valuation):

Proposed source of repayment:

Do you have site control?

Proposed Development Team

Developer:

Architect:

General Contractor:

Property Manager:

Construction Status

Start Date:

Month

Day

Year

Completion Date:

Month

Day

Year

* For income-producing projects, including commercial and multi-family housing projects, please send an operating pro-forma via email (nationaltrust_loanfunds@nthp.org) or fax (202-588-6475) with the name of the project clearly marked. Preliminary inquiries for income-producing projects will not be reviewed until operating pro-forma is received.

Sources and uses of financing:
(please put an asterisk after sources that are already committed)

Name of Source/Amount

Total Source Amount ($)

Name of Use/Amount

Total Use Amount ($)

Legal status of borrower's organization:
501(c) 3
LLC
Corporation
Other

If "other" please specify:

Does your organization have a current business plan?

Has your organization completed similar projects in the past?

If yes, list other completed projects:

Has the historic significance of the property been established by listing on the National, state or local Register of Historic Places or determination of eligibility for listing by the State Historic Preservation Office?

Will rehabilitation conform to the Secretary of the Interior's Standards for the Treatment of Historic Properties?

Thank you for completing an Information Request Form. If you provided project information, a Loan Funds representative will contact you to let you know if you will be invited to submit an application. If invited, the application must be accompanied by all required attachments and a non-refundable $125 application fee.

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