Welcome to the Center for Local Government

www.c4lg.org

The Center for Local Government
Ohio Capital Asset Financing Program
Application

Please complete the following application
OR
print a Capital Asset Financing Application
in Adobe Acrobat© .pdf format to fill out and fax.

* - Required Fields

* Jurisdiction Name:
* County:
* Governmental Type:	Other:
* Contact Name:
* Title:
* Phone:
* Fax:
* Address:
* City:
State:	Ohio
* Zip Code:
* Contact E-mail:
* General Project Description:
When are funds needed (date estimate)?*
If land is being purchased, how will the land be used:	economic development governmental use other
* Itemized Project Cost:
* Dates of Next 4 Board/Council Meetings
* Has money been spent on the project which is to be reimbursed?	Yes No
* Do you currently have debt outstanding for this project?	Yes No
If yes:	Short term (notes) Long term (bonds)
* Term of financing for project (in years 1-25):
Source of payment for project:	General Fund Enterprise Fund Dedicated Levy Other
Other information you would like to share:
How did you hear about the OhioCAF program?: