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NIA -the Redevelopment Commission is requesting asub-grant of up to $200,000 for this <br />remediation. No repayment will be required. <br />DAB <br />•~ ~ ~ <br />1. Co-Signer(s)/Guarantor(s) N/A Phone: <br />Address: SSN: <br />2. Co-Signer(s)/ Guarantor(s) Phone: <br />Address: SSN: <br />3. Co-Signer(s)/Guarantor(s) Phone: <br />Address: SSN: <br />4. Co-Signer(s)/Guarantor(s) Phone: <br />Address: SSN: <br />• <br />Type of Business: ^ Manufacturing ^ Retail ^ Wholesale <br />^ Service ® Other Government <br />Legal Structure of ^ C-Corp ^ S-Corp ^ Limited Liability <br />Company <br />Business: ^ Partnership ^ Sole Partnership ®Other Government <br />State of Registration Date Started: <br />Business Location: ^ Owned ^ Home-Based ^ Leased, expires <br />Job Information: Number of Employees: N/A <br />Estimated # of Jobs to be Created: <br />Estimated # of Jobs to be Saved: <br />• ~ <br />List all owners and key managers of your business. Attach Management Resumes for those listed <br />below. <br />Name Title /Position % Ownership Years w/Company <br />City of South Bend Page 2 of 3 Final Application <br />