Grants - CDRLF

Community Development Revolving Loan Fund - Loan and Grant Programs, 12 CFR Part 705

Reimbursement Request Example_022618

Grants - CDRLF

OMB: 3133-0138

Document [pdf]
Download: pdf | pdf
010210345

6789

/012345261445789:2;04<=7>2=728?52@ABCDEDFGHIJKFGLBMN257O=407P578

QRSTUSVWXYRZ

[\]^_]^_`a_bc`defb_gh_i\b_`eef]j`i]ga_klb^i]ga^_m]i\_m\]j\_ngl_m]ff_ob_epb^baibqr_si_]^
pbjgddbaqbq_i\`i_ngl_jgdeg^b_i\b_`a^mbp^_ig_i\b_e`p`tp`e\_klb^i]ga^_]a_`_mgpq
epgjb^^]at_epgtp`d_`aq_i\ba_jli_`aq_e`^ib_i\`i_ibci_]aig_i\b_gaf]ab_`eef]j`i]gar

uYvwxywWzv{YRZxwUYv

|}~€~€~}~‚ƒ„…}†„…~‡ˆ‰Šˆ†…‹„…~€~‚„…‹ˆ†‚„…ƒ‚ƒƒ„Œ~€€„‚‰ƒ~‹‰ƒŽ†„ˆˆ~~€ƒ‘

’“x”•wxwUYv
_p`jibp_d`c]dld—
–[bci—–˜™™_j\`
’XUR›wWœxZS
–[bci—–™_j\`p_`jibp_d`c]dld—
’žx›wWœxZS
–[bci—–™_j\`_p`jibp_d`c]dld—
’uRSŸUwW vUYvWuYvwxywW¡Uw”S
_
–[bci—–¢™_j\`p`jibp_d`c]dld—
’¡S”S£¤YvS
–[bci—–¥™_j\`_p`jibp_d`c]dld—
’¦§ZxU”W¨ŸŸRS››
–[bci—–˜™™_j\`p`j_ibp_d`c]dld—
’uYvwxywW¡©£S
–ª]atfb«ªbfbji_¬]_^i—
­p]d`pn_®gai`ji
ªbjgaq`pn_®gai`ji

sa^iplji]ga^š
_
sa^iplji]ga^š
_
sa^iplji]ga^š
_
sa^iplji]ga^š
_
sa^iplji]ga^š
_
sa^iplji]ga^š
_
sa^iplji]ga^š
_



11

1
1

1!!"#$$2%&
'(#)*+,&#&- 410.

010210345

/01234526473893:70;26473

6789

<=>?@>AB>CDEFAFGHCAIC>JDKAHLDGLM@AN?LODLPADLEGCQ?KDGLAN>=GRA?LJADLJDI?K>ADEAKS>AIC>JDKAHLDGL
S?@AIS?LP>JAN?LODLPADLEGCQ?KDGLAEGCA?LA>=>IKCGLDIAEHLJ@AKC?L@E>CATUVWXY
Z[\]^\]
T_DLP=>`_>A=>IKAaD@KX
bC>JDKAcLDGL
dL@KCHIKDGL@e
A
V>J>C?=AbC>JDKAcLDGL
Zfgg0hii
dL@KCHIKDGL@e
TW>jKXTkllAIS?C?IK>CAQ?jDQHQX
A
Z\46m
dL@KCHIKDGL@e
TW>jKXATnlAIS?C?IK>CAQ?jDQHQX
A
dL@KCHIKDGL@e
Zo626h
A
A
T_DLP=>`_>=>IKAaD@KX
TpGKAqrr=DI?N=>X
q=?N?Q?
q=?@O?
qQ>CDI?LA_?QG?
qCDsGL?
qCO?L@?@
qCQ>JAVGCI>@
qECDI?tb?L?J?tUHCGr>tuDJJ=>AU?@K
qCQ>JAVGCI>@AqQ>CDI?@AT>jI>rKAb?L?J?X
qCQ>JAVGCI>@AIKDIHK
w>=?R?C>
wD@KCDIKAGEAbG=HQND?
V>J>C?K>JA_K?K>@AGEAuDICGL>@D?
V=GCDJ?
x>GCPD?
xH?Q
y?R?DD



11

1
1

1!!"#$$2%&
'(#)*+,&#&- 010.

010210345

01234
05567468
0716272
0492
:27828
:;7<=>?@
A4=686272
B267;
B2C83255D0852718
B2C@5271
B2882>3=8;<<8
B6>36E27
B677;84<2
B6886886FF6
B6884=C6
B47<272
G;HC28?2
G;I212
G;9DJ2KF836C;
G;9DL;C8;@
G;9DB;M6>4
G;9DN4C?
G4C<3DO2C45672
G4C<3DP2?4<2
G4C<3;C7DB2C6272D0852718
Q364
Q?5234K2
QC;E47
R252=
R;778@5I2762
R=;C<4DS6>4
S341;D085271
T4=<3DO2C45672
T4=<3DP2?4<2
U;77;88;;

6789



11

1
1

1!!"#$$2%&
'(#)*+,&#&- .10/

010210345

/0123
4526
7089:;5
7<8=<;>?3@2;A3
7<8=<;<2
B236<;=5:;
B035>7<8=<;<2
B<3C:;3<;
BD:9<;=

EFGH
I/015>JIKL>C6282C508>921<9M9J
EOPQRSTUVWGXYPWGZVR[\]^U_
>
I`M9a08JIb>C6282C508>921<9M9J

En_UTGWRoVGZVRpo[qR[\]^U_
>
I`M9a08JIb>C6282C508>921<9M9J
zP{]UVWR^{R|}UYW_ZVGYR~\VTRO_PV€U_
|~O‚
I`:><>;gM5>80ƒM<80AJ

6789

?;358MC5<:;3N
>
?;358MC5<:;3N
>
c@0230>0;508>b>A<=<53>:;@Dd>A:>;:5><;C@MA0
2>A236e>f:8>0129g@0N>hKijkljKm
?;358MC5<:;3N
>
c@0230>0;508>A<=<53>:;@Dd>A:>;:5><;C@MA0>2
A236e>f:8>0129g@0N>ijkljKmmh
>
f:8>2>r4`s>;M9a08>C2@@>htluutiLjtjihh>:8
=:>5:>655gNvvw0A=:xeA;aeC:9vy0aw:89
?;358MC5<:;3N
>
>
?;>2CC:8A2;C0>y<56>560>r0a5>„:@@0C5<:;
?9g8:x090;5>…C5>:w>hbbu>IcMa@†2y>hLmt
hkmJ‡>560>`„4…>9M35>92ˆ0>g2D90;53>5:
C80A<5>M;<:;3>aD>‰@0C58:;fM;A3>/82;3w08
I‰f/Je
>
f:8>…„Š>582;32C5<:;3‡>/8023M8D>80ƒM<803
`„4…>5:>M30>ZV}{>2>C60Cˆ<;=>582;32C5<:;
C:A0>y<56>2CC:M;5>;M9a083>25>@0235>m>A<=<53
<;>@0;=56‡>2;A>ZV}{>C:;52<;>;M9a083‡>3g2C03‡
:8>A23603>I;:>A0C<92@3Je>z}UPUR‹U_G€{RŒGW



11

1
1

1!!"#$$2%&
'(#)*+,&#&- $10.

010210345

FG>5H45I3J5@02K>74053B8>5I9
E
LMNOPQRS

6789

/01234567471740537893:0229:73;<=3>5?
>::0157345@03@023ABC3169D
E
TUOVWXYVZRUO[
E
T\E]RXE^WNEX_`^VZUaE]RXWEb^UcZUa
ZU\RWd^VZRUeE_fN^ONEONfNYVEgMNOgE^U`EX_`^VN
VhNEZU\RWd^VZRUEbNfRijET\EURVeEONfNYVEgQRg
^U`EONfNYVEgk^lNE^U`EmWRYNN`gj

Fn45>5:4>o3J56747174053=>K9
E
LpNqVSLrssEYh^W^YVNWEd^qZdXdS
FA::01573C0o?923=>K9
LpNqVSLrssEYh^W^YVNWEd^qEZdXdS
FA::0157356473=0D3};<=~
LpNqVSLrssEYh^W^YVNWEd^qZdXdS E

TUOVWXYVZRUO[
E
TUOVWXYVZRUO[
E

€t9569314?9o4596

TUOVWXYVZRUO[
E

9592>o3€t9569314?9o4596
‚ffEYWN`ZVEXUZRUOEdXOVE^`hNWNEVREVhNE\RffRiZUaENq_NUONEaXZ`NfZUNOE^OEVhN]E_NWV^ZUEVREN^Yh
aW^UVEZUZVZ^VZlNj
‚ffENq_NUONOEdXOVEbNE`ZWNYVf]EWNf^VN`EVREVhNEO_NYZƒYEaW^UVEZUZVZ^VZlNjE„UYNE^i^W`N`eE^
Yh^UaNEZUEZUZVZ^VZlNEiZffEURVEbNE^__WRlN`E^U`E^U]EOXbON…XNUVENq_NUONOEURVEWNf^VN`EVR
VhNE^__WRlN`EZUZVZ^VZlNEiZffEbNE`NUZN`j
„UYNE^__WRlN`E\RWE^E_WR†NYVEXU`NWE^EO_NYZƒYEZUZVZ^VZlNeE^i^W`NNOE^WNENUYRXW^aN`EVR
URVZ\]E„kw‡TEZUEiWZVZUaE_WZRWEVREZUYXWWZUaENq_NUONOEVRE^lRZ`EZOOXNOE^VEVhNEVZdNER\
WNZdbXWONdNUVEOXbdZOOZRUj



11

1
1

1!!"#$$2%&
'(#)*+,&#&- .10.

010210345

6789

/01234566378693:;5<=>:?;3;65@5=6;3A:7B;CD?358E5CFD;E3583DG;3@:F8D3585D5FD5H;3E;DF56?3>A
D73DG;3D7DF63@:F8D3F<7>8DI3JH5E;8C;37K3AF9<;8D3FKD;:3DG;3@:F8D3FAA:7HF63<>?D3=;
?>=<5DD;E345DG3DG;3:;5<=>:?;<;8D3:;L>;?DI
JMA;8?;?3;65@5=6;3K7:3:;5<=>:?;<;8D3<>?D3=;3AF5E3NOPQR3DG;3@:F8D3FAA65CFD57835?
FAA:7H;E3F8E3SQOTRQ3DG;3@:F8D3C7<<5D<;8D3;MA5:;?I3/73;MC;AD578?345663=;35:;E3D73K766743/0123U;DD;:3D730:;E5D318578?3VWX01XYV3Z[G5:E3\F:D9
];:H5C;3\:7H5E;:?^3:;@F:E58@3E>;3E565@;8C;I3[G5:E3AF:D93H;8E7:3F@:;;<;8D?3<>?D3=;
?>=<5DD;E34G5CG358C6>E;3A:7H5E;E3?;:H5C;?_A:7E>CD?3F8E3F??7C5FD;E3C7?D?I
078D:FCD7:3K;;?3DGFD3F:;387D3?>=?DF8D5FD;E35834:5D58@3583F3AF:D8;:?G5A_C78D:FCD7:`?
F@:;;<;8D34566387D3=;3:;5<=>:?;EI
a8H75C;?3K:7<37>D?5E;3AF:D5;?3<>?D3=;3=566;E3D73F8E3AF5E3=93DG;3C:;E5D3>8578I
b;5<=>:?;<;8D?345663=;3857837869I3\F9<;8D?3D73C:;E5D
>857837cC5F6?3F8E3A;:?788;634566387D3=;3FCC;AD;EI

deQfghgSfQijklQemQm
a83FEE5D5783D73DG;3@;8;:F63;MA;8?;3@>5E;658;?n3F663C:;E5D3>8578?3?G7>6E3FH75E3>?58@3@:F8D
K>8E?3783DG;3K7667458@358;65@5=6;3;MA;8?;?I
oF:p;D58@3JMA;8?;3U5<5DFD578?q
r;8;:F6385783F:;387D3A;:<5DD;EI
oF:p;D58@3;MA;8?;?3F:;387D3A;:<5DD;E3K7:3DG;3U;FE;:?G5A3s;H;67A<;8D
585D5FD5H;I
a837:E;:3K7:3?D3?DFD;38E;:3DG;3@:F8D3585D5FD5H;I3t7:3DG7?;3585D5FD5H;?n3?D3=;3F??7C5FD;E345DG3DG;3?A;C5uC3@:F8D3A:7B;CD3F8E3<>?D3=;36;??
DGF83Yvw37K3DG;3D7DF63@:F8D3F4F:E3x;I@I3F3yznVVV3@:F8D35?365<5D;E3D73F3yWnVVV
:;5<=>:?;<;8D3583;65@5=6;36D3F:;358;65@5=6;3>?;?37K
@:F8D3K>8E?q
]F6F:5;?_AF9<;8D?3D73;6DF8D?n3AF:D8;:?37:3H;8E7:?I
078D:FCD?n3F@:;;<;8D?37:358D;:8?G5A?3@5H;83D73C:;E5D3>85783;?37A;:FD578F63;MA;8?;?3F:;358;65@5=6;3>?;?37K3@:F8D3K>8E?q
0>?D7E5F63?;:H5C;?I


11

1
1

1!!"#$$2%&
'(#)*+,&#&- 210.

010210345

6789

011234523678679:;75<9=
>415<:FI34523455B4F3;4@5<7545?73?19<938163<7?:5@?4F39BCC16<=
D59B645?73?19<9=
J67C4@237KC7597939B?:34937KC759793<:73?672@<3B5@153:493C4@23C6@163<1367?7@E@5A
A645<34CC61E4F=
J61;1<@154F3@<7;939B?:3493A@8<9L3A@E74M4I9L391BE75@69L34523A@8<3?4629=
N7?B66@5A31C764<@154F37KC7597939B?:3493675?@ABC>DEE=FGHIHFB@I=JHAKJLJC
/01234RST80138624U139
MNOBILFBKPNOQ
=
>VHB@C
=
U8W831X4Y90Z8[9412\4Y9[;083]4^06_9[3
Y9X9[39\48243`94aTTX8[138624
=
>bG@FcdPA=eKOBC
f@IOPNgBPgh@IOPN=hHiJ@NBO=>fjfC
kKll=fHi
kKPJ@BIKF=PI=JLlBKgmHFBPI=HLBG@NBKFHBKPN
OiOB@JO
bid@I=O@FLIKBi=IKOc=HNn=BIHNOHFBKPNHl
JPNKBPIKNo
bid@I=p@FLIKBi=?IHKNKNo
VHBH=FlHOOKqFHBKPN=hPlKFi
VHBH=@NFIihBKPN=HNn=hIPB@FBKPN
V@dKB=HNnrPI=fI@hHKn=bHInO
VKoKBHlrsl@FBIPNKF=pKoNHBLI@O
sgOBHB@J@NBO
MNOBILFBKPNOQ
=
tHluHI@=n@m@NO@O
tPdKl@=kHNcKNo
tPdKl@=vHll@B=HNn=nKoKBHl=hHiJ@NBO
tPdKl@rwNlKN@=ePHN=xhhlKFHBKPNO
tPdKl@rwNlKN@=t@Jd@I=HNn=pGHI@
xhhlKFHBKPNO
wNlKN@=kHNcKNo=>KNB@IHFBKy@=HNn
BIHNOHFBKPNHl=u@dOKB@z=JPdKl@=HhhOC
wNlKN@=dHNcKNo=O@FLIKBi=LhoIHn@O
{@JPB@=V@hPOKB=bHhBLI@
pPmBuHI@=O@FLIKBi
piOB@J=B@OBO=PI=IKOc=HOO@OOJ@NBO=OLFG
HO=h@N@BIHBKPN=HNn=yLlN@IHdKlKBi=B@OBO
RX8W81215797?51234>
>17@?A><1@18B2732B01C2=>12=<<4D7=B1E267B0
4812432B0124F1DB<234>2B07<2787B7=B7G1H
IA8E<2@=C284B2?12A<1E2B42D4G1>2B01
4;1>=B78921:;18<1<2432=821:74F1DB24>
9181>=521JA7;@18B21:;18<1<2A8>15=B1E2B4
B0129>=8B2787B7=B7G12K1H9H27L=E<2=8E
D4@;AB1>=8B2@=C284B2?12A<1E2B4
D4G1>2B0121:;18<1<2432=2;>4F1DB2B0=B26=<
=5>1=EC2782;>49>1<<2;>74>2B429>=8B2=;;>4G=5H
N42B42B012O:;18<12NA7E15781<2<1DB748234>
=EE7B748=52E1B=75<2=?4AB215797?512=8E
7815797?512A<1<24329>=8B23A8E

4F1DB2<1BA;Q2<1>G7D1Q =8E2BA;2D42180=8D1@18B 3112=B197D2;5=88789 311<234>215797?512;>4F1DBU1B78921:;18<1<2@A=8B2;>4F1DB2=8E @A=8B2K1H9H2=2YZQ[[[29>=8B2;>4F1DB27< 57@7B1E2B42=2Y\Q[[[2>17@?A><1@18B234> 15797?512@=>U1B78921:;18<1=787892D44F1DBADB7481E7B2A8748<2=>12;1>@7BB1E2B42A<12B07< ]^_`abcdefgah`eigjkdl`menjgeo_p_`ace]dgq_ldm 9>=8B2B427@;51@18B24>2180=8D12=8C2432B01 E797B=52<1>G7D12<1DA>7BCQ2=8E23>=AE re]dl^g_`seth_`_a`_qd 2 ;>1G18B7482=DB7G7B71<2782B012574F1DB4F1DB<2B0=B2=>1284B25712;>407?7B1E =8E26755284B2?12>17@?A><1EH o_p_`ace]dgq_ldere]dl^g_`seigjkdl` tvwcdvdh`dxe KS01DU?4:2y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`abcd[e[fgbh[ijck^gl[mjcn[f[mj[] q4261CB6@342r 8 8 M0W0A37898;949J0;04682CBB022@34 7A94o M0W0A37898;@431@6:894I8R3;04 @4BAC2@3487A94 TG69@48;@431@6:894I8R3;048@4BAC2@34 619@4@4J M0W0A37873A@B@028p8713B0IC102894IO31 732@6@348I02B1@76@3428D318022046@9A8B10I@6 11  1  1  1 !   ! "#$$2%& '(#)*+,&#& - 4310. 010210345 /01203425678 946:;63:3<:46643;4:<=37;4:;6>?3@24360;4?A 56B653243C1DA<:46643E271;12078 F042553:036CE52?663103:DB:0<6D3;4:1010> <2/47673;2360G:0<63G17HG64356:D647G1E 7=1557 F042553:036CE52?663103:DB:0<6D3;4:1010> <2/47673;2360G:0<632E64:;120:5 =02I56D>6 J4>:01K:;12073;G:;3:7717;3C10241;? >42/E73;232L;:10310;6407G1E3:0DH24 6CE52?C60;32EE24;/01;167 920;4:<;3:346<60;3>4:D/:;632437;/D60; 10;6403;23:7717;3;G63<46D1;3/01203103:0 :46:32@3066D MNOPNQRSTUVWNXNYZU[N\]V^QZ_N`] WNR`QTU]TZ\ ab:4:>4:EGca3deee336fE607673:463651>1L563@24 461CL/476C60;31@3;G6?3:463:772<1:;6D3I1;G 20632@3;G637/1;:L563E42o6<;73@243;G173101;1:;1B68 p/0D73C:?302;3L63/76D3;23<2B643;G6 2E64:;10>36fE6076732@3:036f17;10>3E42o6<;324 >6064:536q/1EC60;36fE607673/0465:;6D3;2 ;G63>4:0;3101;1:;1B637/4:0;3C:? 02;3L63/76D3;23<2B643;G636fE6076732@3: E42o6<;3;G:;3I:73:546:D?3103E42>46773E41243;2 >4:0;3:EE42B:583t23;23;G63FfE6076 t/1D651067376<;1203@243:DD1;120:53D6;:157 :L2/;3651>1L563:0D310651>1L563/76732@3>4:0; @/0D783 9207/5;10>3:0DH2437;4:;6>1<3E5:0010> @6673@243;G63D6B652EC60;32@3E5:07 a7/<<6771203E5:0010>s3D6B652EC60;32@ 11  1  1  1 !   ! "#$$2%& '(#)*+,&#& - 4410. 010210345 NOPQRSTUVPWXRYPZP[\]^ 3 6789 /012213410/5362072189:;3841042<=>324/?@ 0A73;B6:/:28? CA1B66D2A430A7312<:84104:BA3E2283EB1 07F0A/273410:A:A<3/BG18283HDG843I2 /BD;624273J:49:A34923<10A434:D2E10D2@? K4:;2A73;0:734B312/2A43<107G0423B1 84G72A43:A421A? LG:4:BA312:DIG182D2A43EB13/BG1828 126042734B362072189:;372F26B;D2A4 0A7MB13/127:43GA:BA3B;2104:BA8? _A841G/4:BA8` 3 aB1303b2/2A43c107G042` b2/2A43<107G04283D0=3BA6=3I2 /BD;2A804273491BG<930384:;2A7 7G1:A<34923<10A43;21:B7? CD;6B=D2A43126042732d;2A8283012 AB43;21D:44273GA721349:83;1Be2/4? fG84390F23/BD;62427>3J:49:A3492 ;12F:BG83/062A7013=201 H<107G04:BA370423DG843I2 I24J22A3g0AG01=3hijk3l3;1282A4@> 03mG06:E=:A<3088B/:0428>3I0/926B18> D084218>3;1BE288:BA06>3B1 7B/4B1042372<1223E1BD30A 0//127:427327G/04:BA063:A84:4G4:BA? _E30;;1BF273EB1349:83<10A4>303/B;= BE34923Bn/:063410A8/1:;4>3128GD2> 0A73/214:o/04:BA3BE3;0=D2A43EB1D 8:1=:1623G PQRSSTUVWXTWRYRZ[\]T^_`abZ\TPbSbZ\bcT[d \ebTfYYS[ZR\[`d gMD6Bh59i4j<23k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

2=B197D2;5=88789 311<234>215797?512;>4F1DB=DB789267B02=2D48>18B2B1D084549C2=B2B01 D>1E7B2A87482=8E27E18B73C2A;9>=E1<24> 180=8D1@18B81C2311<2B42>1G7162E=B=2;>4D1<<789 D48B>=DB< Q=B=2;>4D1<<7892311<2=<<4D7=B1E267B0 =8=5CB7D1 D48G1><748G1>< =8E25=;B4;<2=>12;1>@7<<7?512=<2481R B7@12S:1E21:;18<11 ;1>@7BB1E2485C2732B0121JA7;@18B27< =G=75=?51234>2A<12?C2=552@1@?1> 1:=@;51K27U=E<2B0=B267552?12A<1E2=<2= B1551>22@1@?1>4F1DB2<1BA;K2<1>G7D1K =8E2BA;2D42180=8D1@18B 311Y1B78921:;18<1<2@A=8B2;>4F1DB2=8E @A=8B2T1H9H2=2]^K___29>=8B2;>4F1DB27< 57@7B1E2B42=2]`K___2>17@?A><1@18B234> 15797?512@=>Y1B78921:;18<1242?>: @07A:698B S3890T692738U 5 V:>7<510:59=:5?T;4:95:W@:38:85XYZ[5=18 1@@07\:;5]7059=:560:;295T3273^85@07A:69B _:2`?T08:`:3985]705:16=5:W@:38: ;:8602@92735<2>>5?:5>2`29:;59759=:51`7T39 23;2619:;57359=:5>289B abcddJefghJgcDcijNkJlEFmHiNJfbDdHbHQNHI 5 nY=:6o?7W5p289q Y73\:092345`13T1>560:;295T3273 7@:01927385975135:>:6907326r51T97`19:; S3890T692738U5 @076:88B y:>:6959=:5@07A:6959=:560:;295T3273528 Z@401;23457@:0192731>59:6=37>74s 0:tT:892345150:2`?T08:`:395]70B5 61@1?2>292:8B 5 [6tT202345T@;19:;59:6=37>74s597 S]59=:5@07A:6952859=:581`:51859=:573:58:>:69:; 2`@07\:59=:560:;295T3273u85?16ov7w6: 2359=:51@@>2619273r59=:358:>:6959=:581`: 7@:0192738B @07A:69B x9=:059:6=37>74s5@07A:6985;:8243:;597 2`@07\:59=:560:;295T3273u857@:0192731> 13;57T90:16=561@1629s zN{HEJabcddJefghJgcDcijNkJlEFmHiN fbDdHbHQNHI n/:W9qn|}}56=150169:05`1W2`T`q S3890T692738U 5 ~39:0515\:0s5?02:]5@07A:695929>:570531`:57] 9=:5@07A:6959=:560:;295T327352850:tT:8923451 0:2`?T08:`:395]70B5n>:18:5>2`295975|}} 6=10169:08q5 5 S]59=:5@07A:6952859=:581`:51859=:573: 23;2619:;52359=:51@@>2619273r59=:35:39:059=: 81`:5929>:B €FNcdJlEFmHiNJgFRNJCiNLcd‚ nYT00:36sqnƒ}56=10169:05`1W52`T`q S3890T692738U 5 ~39:059=:59791>567895n169T1>q57]59=:5@07A:69B 11  1  1  1 !   ! "#$$2%& '(#)*+,&#& - 4.10. 010210345 6789 /01234567869167:964 ; <=>?@A BCD?EFG?HICDJ ; KL@C;MHM;?L@;GE@MH?;FCHIC;D?>E?;?L@ NEIO@G?P /01234567QRS7:964 ; <=>?@A BCD?EFG?HICDJ ; KL@C;MHM;?L@;GE@MH?;FCHIC;GITNU@?@;?L@ NEIO@G?P /V4WXYZ1[4X4R67V4\Z4[67]X2ZR6 <^FEE@CG_A<`a;GL>E>G?@E;T>bHTFTA ; BCD?EFG?HICDJ ; cC?@E;?L@;MIUU>E;>TIFC?;_IF;>E@ E@dF@D?HCe;fIE;E@HTgFED@T@C?h;CI?;?I @bG@@M;?L@;>NNEIi@M;>TIFC?j BCD?EFG?HICDJ ; rL@;fIUUIsHCe;MIGFT@C?D;>E@;D>?HDf>G?IE_ @iHM@CG@;?I;DFgTH?;>D;>;NEIIf;If;NFEGL>D@j c>GL;MIGFT@C?;_IF;FNUI>M;DLIFUM;GIC?>HC;> C>THCe;GICi@C?HIC;DFGL;>D;tEIIf;If tFEGL>D@;qh;tEIIf;If;tFEGL>D@;`h;>CM;DI;IC >D;C@@M@Mj;rL@;E@HTgFED@T@C?;E@dF@D?;sHUU g@;E@?FEC@M;?I;?L@;GE@MH?;FCHIC;Hf;?L@;C>THCe 0122k72k70Z15l9[47QmWS4R54 GICi@C?HIC;HD;CI?;GITNU@?@M;NEIN@EU_j; ; ; MAnHU@;oNUI>Mp;qaaaaaaa;g_?@;UHTH? 0122k72k70Z15l9[47Qu9Xvw4[ =@?>HU@M;BCiIHG@ KIEx;yEM@ED z@G@HN?D {HeC@M;^IC?E>G?D 0122k72k709|X4R67QmWS4R54 BCD?EFG?HICDJ ; MAnHU@;oNUI>Mp;qaa;aaaaa;g_?@;UHTH? rL@;fIUUIsHCe;MIGFT@C?D;>E@;D>?HDf>G?IE_ @iHM@CG@;?I;DFgTH?;>D;>;NEIIf;If;N>_T@C?j 11  1  1  1 !   ! "#$$2%& '(#)*+,&#& - 4210. 010210345 kl]XRPQRNOPmVnXRoVWpPO] `q?9Drd9h:954s@?;c 4 6789 01234562789:;4<6747=>6154?367>5426:;1@:41 :18@:A426:B9:;@6:4?72341?4CD66E46E C1<89:;4FG4CD66E46E4C1<89:;4HG41:54?646:41? :99595I4J394D9@8K7D?989:;4D9L79?;4M@>>4K9 D9;7D:954;64;3942D95@;47:@6:4@E4;394:18@:A 26:B9:;@6:4@?4:6;4268=>9;954=D6=9D>91D954^392_?4`D9L7@D9?4;39 ED6:;41:54K12_46E42>91D9542392_4ab41 2>91D9549>92;D6:@2426=<4M@;342>91D1:29 @:E6D81;@6:c d9;1@>954^1D54e;1;989:;?4`=1<89:; 1867:;41:54B9:56D4:189487?;4K9 >@?;9542>91D>?4?72341?4;D1:?12;@6:4jdG41867:;G ;D1:?E9D4?;1;7?G41:5451;9c j:?;D72;@6:?t 4 s@?;4;394:18946E4;394B9:56D?47?954E6D4;39 =D6u92;I4J394>@?;487?;4K94?7K8@;;954@:4;39 E6D81;4K9>6MI4J394D9@8K7D?989:;4D9L79?; M@>>4K94D9;7D:954;64;3942D95@;47:@6:4@E4;394>@?; @?4:6;4268=>9;954=D6=9D>6A<4e6>7;@6:?4r4„6K@>941:_@:A €HG‚‚4r4C7D231?94d624H4r4C1<89:;4d624H 11  1  1  1 !   ! "#$$2%& '(#)*+,&#& - 4.10/ 010210345 6789 XYZV[\]VEJYZ^ B /012304356789:3;<9=>7<81?3@1:09A JKLBKB]JIUBJ_BV`GBJa]EKFBV[KYZ][EIVB_J[ CDEFGBHIFJKLMDEFGBHIFJKLNBOPQPRRSBTUBVGBFEWEV V`GHIF BbV\LGYVBXYVG[YcdG]GYVBe[KL\KVGf XYZV[\]VEJYZ^ B gh>ijh3@1:09A HIFJKLBKB]JIUBJ_BV`GB[GZ\WGB_J[BV`G CDEFGBHIFJKLMDEFGBHIFJKLNBOPQPRRSBTUVGBFEWEV bV\LG YVBXYVG[YcdG]GYVBe[KL\KVGf XYZV[\]VEJYZ^ B DJFFJnBV`GBZVGIZBTGFJnBVJB]JWIFGVGBV`G oG[VEp]KVEJYBJ_BqKUWGYVB[Gr\E[GWGYVZfB B sfBtJnYFJKLBV`GBoG[VEp]KVEJYBJ_BqKUWGYV /h3043y?iAh=?3z=?h<={gh7h=?3|<9Ai9?h YVG[BV`GBYKWGBJ_BV`GBbV\LGYV BXYVG[YcdG]GYVBe[KL\KVGBKYLBKLLBVJBV`GBFEZVf CHZG[}tGpYGLB~EZVM XYZV[\]VEJYZ^ B uGBV`GBZV\LGYVBEYVG[Yc[G]GYVBv[KL\KVG y?iAh=?3z=?h<={gh7h=?3|<9Ai9?h€3l<0h7? n[EVƒK GBKBZVKVGWGYVBLGZ][ETEYvBV`GBEWIK]VBJ_ 5i?70jh3yijj9<2 `EZc`G[BG‚IG[EGY]GBKVBV`GB][GLEVB\YEJYBKYL CqK[Kv[KI`MCPSSSB]`KB[K]VG[BWK‚EW\WM `JnB`EZc`G[BG‚IG[EGY]GBnEFFBTGYGpVBV`GWBEY V`GB_\V\[Gf m8=9:3gh>i:?>3043?„h3l<0h7?3 B XYZV[\]VEJYZ^ B 11  1  1  1 !   ! "#$$2%& '(#)*+,&#& - 4510. 010210345 6789 /0123245617831236043594:163;8178<2 7==796;816>3673=97?1:431821@0623AB7;63604 =97C45634D=49148543A8:3:42591B43A8> 7B249?A617823AB7;636043@9A8634D=4914854E FGHI JKA93A@9A=0LJMNNN350A9A56493OAD1O;OL P8269;561782Q 3 R42591B4307S360123@9A8631O=A564:3604 594:163;81783A8:307S316304T=4:36043594:16 ;81783B466493249?436043;8:49249?4: O4OB4923A8:357OO;816>E FUH JKA39A@9A=0LJMNNN350A9A56493OAD1O;OL P8269;561782Q 3 R42591B436043594:163;8178V2318648:4:3@7AT W7936043=97C456E FXH JY432Z[7L P8269;561782Q 3 R1:36043594:163;81783A5014?4316<2318648:4: @7AT\ ]H 39A@9A=0LJMNNN350A9A56493OAD1O;OL JKA P8269;561782Q 3 K97?1:431821@0623A8:3:46A1T2360A6301@0T1@06 07S36043594:163;81783A5014?4:36043:4T1?494: 7;657O4E3^7934DAO=T4_3:42591B4307S3604 594:163;81783O4A2;94:3=97@9422367SA9:23604 @7AT36097;@07;636043=97C456E3 3 P83A::16178_3185T;:43A8>37B249?A61782360A6 04T=4:36043594:163;81783A5014?43604318648:4: @7ATE3K97?1:432=451`53O469152360A63S494 O4A2;94:32;503A238;OB4937W384S3O4OB492 60A63C7184:37938;OB4937W3O4OB492360A63;24 604384S3O7B1T43T7A83A==E ]H 39A@9A=0LJMNNN350A9A56493OAD1O;OL JKA P8269;561782Q 3 11  1  1  1 !   ! "#$$2%& '(#)*+,&#& - 4%10. 010210345 FG 637C37>=JHKLLL62=7372<036B7M4B@BJ HI7 6789 /012345067896:5103;7<4:816<=7<6>30;08<0? <=06230?4<6@84:86A3:B672=40;48C6<=0648<08?0? C:7DE N81<3@2<4:81O 6 N86=48?14C=3:;06<=06>3:R02<6301@D<1678? 72=40;06<=0648<08?0?6C:7DS N81<3@2<4:81O 6 TD42U6<=06VWXYZ[X\][^_`aZZ]6V6D48U650D:Q <:62:8<48@0E bZ_cd[X\][e`\]fgf`\d hDD6230?4<6@84:816730630i@430?6<:6203<4A96<=06A:DD:Q48C6<03B1678?62:8?4<4:816:A6<=06KLjk6l378< m:@8?6486nTohp16T9503l378<6191<0B6>34:36<:62:B>D0<48C676304B5@310B08<630i@017?5@ABC9CCC5>7 2D8DE<=57?5:HD5G:567>;7 I6G:5H:5K;786K:D8O PO5QFG5EDGR;7G>S=D5T;E5:HD5DUK>D7: <785DVDK:>ND5<8I>7>G:E<:>;75;T5:HD 2D8DE<=5QFK<:>;75;T G;6785I<7KDGO5QFS>=>:L5T;E <8I>7>G:DE>7?52D8DE<=52678G5>75<5I<77DE YZ[\]^_\`aZ[bX K;7G>G:D7:5F>:H5678DE=L>7?5NDG95<785:HD5:DEIG5<78 K;78>:>;7G5;T5:HD52D8DE<=5QFK>R<:D85G6SG:<7:><==L5T;E :H>G5dE<7:eT678D85N>:L957;E5;:HDEF>GD SD7DJ:D858>EDK:=L5;E5>78>EDK:=L5TE;I5:HD dE<7:95FH;95:;5>:G5f7;F=D8?D5/7? ED=>?D7KD495H;7GH>Rh5F>:H5<75c0iQ5DIR=;LDD5FH; YZ[\]^_\`aZ[b X REDGD7:=L5H;=8G5<5R;G>:>;75:H<:5F;6=8 D7I5;E5HDE5:;5>7j6D7KD5<5RD78>7? ;E5T6:6ED5?E<7:5IS6EGDID7:5;T5RDEI>::D85DkRD7GDG :HDED678DEO X lO5Q75DIR=;LDD95K;7:E;7GH>Rh5>T5HD5;E5GHD5FDED D>:HDEm5/n45<5IDISDE5;T5:HD5H;6GDH;=85;T <75c0iQ5DIR=;LDD5FH;5REDGD7:=L5H;=8G5< R;G>:>;75:H<:5F;6=85D7I5;E5HDE5:; YZ[\]^_\`aZ[b >7j6D7KD5<5RD78>7?5;E5T6:6ED5?E<7: X IS6EGDID7:5:HDED678DEM ;E5/o45<5ED=<:>ND5;T5G6KH5<75c0iQ5DIR=;LDD F>:H5FH;I5HD5;E5GHD5H;7GH>RO5B50O2OpO5olqBOBCo/S4/n4/>>4O5 AO5QFGK=;GD5>75FE>:>7?5:; YZ[\]^_\`aZ[b X c0iQ5<7L5R;:D7:><=5K;7j>K:5;T5>7:DEDG:5>7 11  1  1  1 !   ! "#$$2%& '(#)*+,&#& - 0410. 010210345 6789 /00123/4056789:6/;;<80/=<56>5352/< /7/2384?6/?540@6;1<80@A6 B CA6D526E6FA>AG6EHHAIIJK6L7/23556MNO9 38O0<1O56/<<6P815352/<6028M84/< N29:52M125K6025389 N4814O6O:1N<3654ON25601M;<8/4056789: ^89<56fg61Q69:56F8P8<6G8?:9O6L0961Q6I]hiA B IHA6gQ6/46L7/2355654952O68491 01MM89M549O6Q126/6;21a5096=5Q12569:5 ?2/4963508O81468O6M/35K6L7/2355678<<6=5 1=<8?/9536916;/@6;21a50965_;54O5O6Q21M689O STUVWXYVZ[TU\ B 1746QN43O6O:1N<369:56258M=N2O5M549 25cN5O964196=56/;;21P53A B IIA6gQ69:56L7/235561=9/84O6MN<98;<56?2/49 /7/23OK6jkFeg678<<614<@6/005;96jdl 258M=N2O5M549625cN5O96Q126/<<6/7/23OA kN=M8OO8146MNO96840 ?=4@=6:@6:A16@=4>45236012034516250 2??=@B106;C6DEFG6?=4@=6:@6G<2=011 45H8==45>61I?15919J K LMJ6NA16G<2=01164962<2=16:A2:6DEFG6<433 H@==19?@506<4:A6:A16H=104:6854@5 =1>2=045>6:A4962??34H2:4@56;C617243 RSTUVWXUYZST[ O8:434P45>6:A16172436?=@B40106456:A49 K 2??34H2:4@5QJ K L\J6G<2=0116A1=1;C62H]5@<310>196:A2: DEFG6=191=B196^8336049H=1:4@56:@6015C =147;8=91715:68501=6:A496_=25:6456:A1 1B15:6DEFG601:1=745196:A2:6G<2=011649` @=6?=1B4@893C6<29`614:A1=6456;=12HA6@^625Ca RSTUVWXUYZST[ H@504:4@56@=63474:2:4@56456:A1 K >=25:b=147;8=91715:6>840134519`6@=645 ;=12HA6@^6:A16cH@B1=106=132:4@59A4?d =19:=4H:4@5691:6^@=:A62;@B1J6 K LeJ6f5^@=72:4@5645H380106456g8:H@71 h8772=C6@=6h8HH1996h:@=4196496H@59401=10 ;C6DEFG6:@6;16i1912=HA6j2:26250649 >@B1=5106;C6k6Eli6m6knnJMLe6250672C6;1 RSTUVWXUYZST[K 72016?8;34H233C62B2432;31J K LoJ6G<2=01164962<2=16:A2:625C6^2391` pH:4:4@89`6@=6^=2808315:645^@=72:4@56@= :A16@74994@56@^625C672:1=4236^2H:`672C 98;q1H:6G<2=0116:@6H=474523`6H4B436@= 2074549:=2:4B16?1523:4196^@=6^=280`6^2391 RSTUVWXUYZST[ K 9:2:1715:9`6^23916H324796@=6@:A1=<491J OFJhJ6E@016N4:316Lr`6h1H:4@56LnnL62506N4:31 ML`6h1H:4@596MsktaMsMn`62506MrnLaMrLkQJ6 K u=@q1H:6N4:31 RSTUVWXUYZST[ KV~XUxVK~yYWz vwxyUzv{||KX}~ K N@:236i147;8=91715:6G7@85:6i1€819:10 RSTUVWXUYZST[ K vWVVxSX‚zv{ƒKX}~V~XUxVK~yYWz K f^6C@862>=116:@6:A16:1=7962506H@504:4@59 RSTUVWXUYZST[ 11  1  1  1 !   ! "#$$2%& '(#)*+,&#& - 0.10/ 010210345 6789 /0123456789/:5;7<258=57>5?13@A71B3= ?53C90?=5C5417?5D05=179A7>/C<25134E71B5 H @/22/F34E734@/?C813/4G H IJ01B/?3K567L?56317M43/47NO>3827P8C5 `abU\_YU^cabd H QRSTUVQWXXHYZ[\[YUS\H][T^]_]V H IJ01B/?3K567L?56317M43/47NO>3827e3125 `abU\_YU^cabd H QRSTUVQWXXHYZ[\[YUS\H][T^]_]V H IfA7>B5>g34E71B3=79/h;7i;71B57801B/?3K56 >?56317043/47?55?13@A71B57JF8?655j= >/C<2384>57F31B71B5789/:5715?C=7846 >/46313/4=G `abU\_YU^cabd QkZSYlmcTHnH^bUV H `HYS\U^opHUZSHUS\]bH[mcqSr Is34827t53C90?=5C5417t5D05=1u H QvSbwxcV `abU\_YU^cabd H `bHUZ^bHUZSHY\Sy^UH_a^cazbH{a[| \S^]m_\bS]SaUH\S}_SbU~Ha|pHcaS \S^]m_\bS]SaUH\S}_SbUH^bH[||c€SyHS\H‚\[aU [|^Y[U^carH`oHUZSHY\Sy^UH_a^caHZ[bH\S][^a^a‚ ‚\[aUHo_aybH[oUS\HYc]|SU^a‚HUZ^bH\S}_SbUƒ xk„…H€^||HY[aYS|HUZcbSHo_aybH[ayH^UH€^||Hac |ca‚S\HmSH[q[^|[m|SHUcHUZSHY\Sy^UH_a^car `abU\_YU^cabd H ‡|S[bSH\cq^ySH^aoc\][U^caHcaH[ap I†5=>?3957>B84E5=7C86571/71B57984g34E YZ[a‚SbH][ySHUcHUZSHY\Sy^UH_a^cazbHm[al^a‚ ^aoc\][U^caH^aHUZSH\‚[a^‰[U^caH`aoc\][U^ca 34@/?C813/4G7 bSYU^carHŠc\HST[]|SƒHYZ[a‚SyHm[alHa[]SHc\ Q‡[\[‚\[ZVQˆXHXXHYZ[\[YUS\H][T^]_]V \c_U^a‚Ha_]mS\rH`oHUZS\SH[\SHacHYZ[a‚Sbƒ |S[bSHUpSHxw…r `abU\_YU^cabd H k|^YlHUZSH‹Œ8:578467?/>556‹H|^alHmS|c€ UcHYcaU^a_Sr 11  1  1  1 !   ! "#$$2%& '(#)*+,&#& - 0$10. 010210345 6789 /001234556789 307:;<0=2>6?=4@07=2>701;82A?;6?2B?CDE=;=2F0G4DC8;6?2H234507:;=;6?2BI6482/>AB JKL2>6?876D2/4@I072MNMMOPNMQ RC507S67T2F014<8;6?2B<8238C80@0?8U2B<<671;?G28628V02RC507S67T2F014<8;6?2B<826W2NXXYZ2C?2CG0?6@@0?8=2<6?<07?;?G28V02C<<47CAF]BRR3^?<4C\G6: /C8;6?CD2>701;82A?;6?2B1@;?;=87C8;6?Z2N__Y2`4T02387008Z2BD0aC?17;CZ2bB2ccMNdOMdcQ e?=50<8672f0?07CD2g2hJeB2g2/62h0C72B<82g2iV;=8D0ID6S072R7680<8;6?2g2A3B\G6:2g2J50?2f6:07?@0?82g2RDC;?2i7;8;?G2g2R7;:C6?8C<82A=2g2F332h001=2g 3;802KC52g23;802e?10a 11  1  1  1 !   ! "#$$2%& '(#)*+,&#& - 0.10.

File Typeapplication/pdf
File TitleNCUA
AuthorINWANKPA
File Modified2018-02-27
File Created2018-02-26

© 2024 OMB.report | Privacy Policy