Is the applicant: A) A qualified authorized issuer of tax-exempt private activity bonds (e.g., State public authority, local Industrial Development Agency (IDA))? OR B) A project applicant that has applied to, and been approved by resolution of, a qualified authorized issuer for the issuance of tax-exempt private activity bonds for such project? (Please see Help Section for additional information)

US Congressional District where the project is located. (This question's value will be filled automatically, based on the project address, when the application is finalized.)

Project Street Address: Please input the project street address (Street Number and Street Name only).

If the project has multiple locations, please input the primary street address of the project. If the project does not have a definite street address, please input the approximate street address of the project (Street Number and Street Name only).

Project City

Project county or counties.

Project State

Project Without a Street Address: please enter a description of the project location. Include project starting/ending street addresses, cities & zip codes if applicable.

Project Latitude (This question's value will be filled automatically, based on the project address, when the application is finalized.)

Project Longitude (This question's value will be filled automatically, based on the project address, when the application is finalized.)

NYS Assembly District where the project is located. (This question's value will be filled automatically, based on the project address, when the application is finalized.)

NY Senate District where the project is located. (This question's value will be filled automatically, based on the project address, when the application is finalized.)

Project ZIP Code. (please use ZIP+4 if known)

For more than one project location, please provide full address(es) for each location. If Not Applicable, indicate "NA".

Based on your selection from the previous question, enter your applicant ID number. (Please do not provide your social security number).

Type of Applicant (select all that apply)

Is the applicant a DBA?

What is the applicant's DBA name?

Select an applicant ID type from the list below that you normally use to identify your organization on application forms.

If you are a business, have you been certified as a New York State Minority or Women-owned Business Enterprise (MWBE)?

Organization Legal Name

Applicant Street Address

Applicant City

Applicant State

Applicant ZIP Code. (please use ZIP+4 if known)

Applicant Telephone Number (please include area code)

Applicant Email Address

Contact First Name

Contact Last Name

Contact Title

Contact Street Address

Contact City

Contact State

Contact ZIP Code (please use ZIP+4 if known)

Primary Contact Phone Number. (please include area code)

Contact Email

Additional Project Contact First Name

Additional Project Contact Last Name

Additional Contact Title

Additional Contact Street Address

Additional Contact City

Additional Contact State

Additional Contact ZIP (please use ZIP+4 if known)

Additional Contact Telephone Number (please include area code)

Additional Contact Email Address

Please select the primary sector or characterization that best defines this project.

Please select the secondary sector or characterization that best defines this project.

Does the project align with the Regional Economic Development Council's Strategic Plan? Click here for strategic plans

Explain how the project aligns with the Regional Economic Development Council's Strategic Plan.

What is the status of State and/or Federal Environmental Review?

Has a National Environmental Policy Act (NEPA) Record of Decision been issued?

Please explain decision and include date of Record of Decision.

Has the applicant or project been awarded funding in prior CFA rounds?

What were the CFA numbers for which funding was awarded? (separate multiple CFA numbers with commas)

For each program to which you are applying under the CFA, explain your strategy for proceeding if the full amount of requested funding, required matching funds, and temporary financing are not secured as expected, or committed sources become unavailable.This explanation must address any proposed project phases, and both CFA and non-CFA sources of funds.

Project Description. Concisely describe the project, indicating the location, what will be planned, designed, acquired, and/or constructed, the issues/opportunities to be addressed, and expected outcomes and deliverables. Additional details will be collected later in the application process.

Statement of need: Provide a brief summary of the need for the project in the geographic area proposed and the project's financing needs, including funding gaps of the proposed project.

Current State of Project Development (i.e. planning, preliminary engineering, final design, etc. You may enter N/A for non-project related applications)

Estimated Project Timeline: include project start/completion dates, estimates for design, permitting and construction or other major steps.

Provide a list of all federal, state, and local reviews, approvals, or permits needed or completed, including the dates when they are expected to be completed or were completed. If Not Applicable, indicate "NA".

Please attach a copy of project applicant's application for financial assistance to the authorized issuer and a copy of the inducement resolution/resolution of intent approved by such issuer for this project.

When does the applicant anticipate closing on the tax-exempt private activity bonds for the project?

Will the proposed project result in the creation of construction jobs? If so, estimate the number of construction jobs to be created. (Enter zero if not applicable.)

Will the proposed project directly or indirectly result in the creation of permanent jobs? If so, estimate the number of permanent full-time equivalent jobs that will be created. (Enter zero if not applicable)

Which type of tax exempt private activity bond will the project qualify for under the federal Internal Revenue Code (IRC sections 142, 144 or other relevant section, e.g., multi-family resident rental housing, small issue manufacturing)?

What amount of tax-exempt private activity bond volume cap is being requested?

Total Project Cost

By entering your name in the box below, you certify that you are authorized on behalf of the applicant and its governing body to submit this application. You further certify that all of the information contained in this Application and in all statements, data and supporting documents which have been made or furnished for the purpose of receiving assistance for the project described in this application, are true, correct and complete to the best of your knowledge and belief. You acknowledge that offering a written instrument knowing that the written instrument contains a false statement or false information, with the intent to defraud the State or any political subdivision, public authority or public benefit corporation of the State, with the knowledge or belief that it will be filed with or recorded by the State or any political subdivision, public authority or public benefit corporation of the State, constitutes a crime under New York State Law.

By entering your name in the box below, you certify and agree that you are authorized on behalf of the applicant and its governing body to commit the applicant to comply with the requirements of Article 15-A of the New York State Executive Law: Participation By Minority Group Members and Women With Respect To State Contracts by providing opportunities for Minority-owned Business Enterprise (MBE)/Woman-owned Business Enterprise (WBE) participation. You further certify that the applicant will maintain such records and take such actions necessary to demonstrate such compliance throughout the completion of the project.