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Strategic Acquisition Form

Contact Information

Contact Name(Required)

Title / Role(Required)

Email(Required)

Phone(Required)

Organization Information

Organization Name(Required)

Legal Name (if different)

Organization Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Legal Structure(Required)

Sole Proprietorship

Partnership

Limited Liability Company (LLC)

Corporation, Nonprofit Organization

Cooperative

Federal EIN Number(Required)

Website

Mission Statement(Required)

Summary of Organization's Work(Required)

Key Staff & Roles

Key Staff & Roles

Staff Name(Required)

Role(Required)

Email(Required)

Staff Name

Role

Email

Staff Name

Role

Email

Staff Name

Role

Email

Property Information

Property Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Property Identification (PID) Number

Property Asset Class

Single Family (1-4 unit)

Multi Family (5+ units)

Commercial

Land

Year Built

Number of Units

Lot Size (square feet)

Building Size (square feet)

Zoning

Current Occupancy

Occupied

Vacant

Not Applicable

Additional Property Information

Acquisition Information

List / Asking Price

Anticipated Offer Price

Anticipated Acquisition Date

Current Listing Status

On-Market

Off-Market

Current Acquisition Status

No Agreement with Seller

Letter of Intent

Executed Purchase Agreement

Purchase Price

Earnest Money Deposit

Closing Date

Please Indicate if the Following Due Diligence Activities Have Been Completed or Are In Progress

Inspection

Appraisal

Environmental Site Assessment (ESA) Phase 1

Environmental Site Assessment (ESA) Phase 2

Title Work

Other

Specify Which Other Due Diligence Activities Have Been Completed

Additional Acquisition Information

Project Information

Name of Project (if applicable)

Project Narrative

Timeline

Anticipated Resale Date

Holding Period Request

Acquisition Funding Sources

Please list all anticipated sources of acquisition funding, including equity (cash, investors), debt (bank loans, mezzanine financing), and incentives (tax credits, TIF, grants)

Source Of Funds 1

Source of Funds

Amount ($)

Asked, Committed, or Secured?

Anticipated Funding Date

Source Of Funds 2 (if applicable)

Source of Funds

Amount ($)

Asked, Committed, or Secured?

Anticipated Funding Date

Source Of Funds 3 (if applicable)

Source of Funds

Amount ($)

Asked, Committed, or Secured?

Anticipated Funding Date

Source Of Funds 4 (if applicable)

Source of Funds

Amount ($)

Asked, Committed, or Secured?

Anticipated Funding Date

Source Of Funds 5 (if applicable)

Source of Funds

Amount ($)

Asked, Committed, or Secured?

Anticipated Funding Date

Project Partners

List Project Partners

One per line. Please list all project partners below (i.e. – lender, developer, consultant, RE broker, architect, general contractor, etc.) Include Organization, Contact Name, Partner Role for each partner.

Additional Project Information

Will the Property by Occupied or Vacant During the Interim Holding Period

Occupied

Vacant

Unsure

Have You Previously Worked with Land Bank Twin Cities?

Yes

No

Which Program(s)?

Strategic Acquisition Program

Community Lending Program

Summary of Relevant Project Experience

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2515 Wabash Avenue, Suite 150, Saint Paul, MN 55114

info@landbanktwincities.org