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<br />Page | 2 <br /> <br />2 <br /> <br />Certification <br />I hereby certify that the balance information included here is from state funded Minnesota Investment <br />Fund grant repayments only. I certify that I have not included any funds from other sources. I certify <br />that I have complied with all local requirements for submittal of this request and will utilize the <br />approved funds as a general purpose aid for lawful expenditures, adhering to any and all local, state or <br />federal requirements as applicable. <br />I have read the above statements and I agree to supply the information requested to the MN <br />Department of Employment and Economic Development, Office of Business Finance with full <br />knowledge of the information provided herein. I certify that all information is true and correct to the <br />best of my knowledge. <br />Certified by: <br /> <br />___________________________________________________________ <br />Local Government Authorized Official Printed Name & Title <br /> <br />__________________________________________ ____________ <br />Local Government Authorized Official Signature Date <br /> <br /> <br />Exception Criteria – Laws of MN 2017, Chapter 94, Article 6, Section 24 <br />ONETIME EXCEPTION TO RESTRICTIONS ON USE OF MINNESOTA INVESTMENT FUND LOCAL <br />GOVERNMENT LOAN REPAYMENT FUNDS. <br />(a) Notwithstanding Minnesota Statutes, section 116J.8731, a home rule charter or statutory city, <br />county, or town that has uncommitted money received from repayment of funds awarded under <br />Minnesota Statutes, section 116J.8731, may choose to transfer 20 percent of the balance of that money <br />to the state general fund before June 30, 2018. Any local entity that does so may then use the <br />remaining 80 percent of the uncommitted money as a general purpose aid for any lawful expenditure. <br />(b) By February 15, 2019, a home rule charter or statutory city, county, or town that exercises the option <br />under paragraph (a) shall submit to the chairs of the legislative committees with jurisdiction over <br />economic development policy and finance an accounting and explanation of the use and distribution of <br />the funds. <br />Request approved by: <br /> <br />_________________________________________ ___________ <br />DEED Loan Officer Date