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<br />CWCB Construction Fund Loan Application <br />Revised January 31, 1994 <br /> <br />2. Are any of the above liabilities now in default, or been in default at any time in the past? <br />YES_ NO _ If "YES", please give detailed explanation: <br /> <br />3. Please provide a summary of all revenues received during the last two fiscal years by <br />category (such as service charges, tap fees, assessments, etc.): <br /> <br />4. Please provide a brief narrative description of potential sources of funding (in addition <br />to the CWCB) which have been explored or which will be explored for the proposed <br />project (Examples would be Banks, U.S. Farmer's Home Administration, Colorado Water <br />Resources and Power Development Authority, etc.) <br /> <br />5. What collateral w:ill you be offering for this loan?: <br /> <br />The above statements are true, to the best of my knowledge: <br /> <br />Signature of Applicant: <br />Title: <br />Date: <br /> <br />5 <br />