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CENTERVILLE REVOLVING LOAN PROGRAM <br />APPLICATION FORM <br />I. APPLICANT INFORMATION <br />Local Business Owner or Non-Residential Real Estate OwnerÓs Name(s): <br />Home Address: <br />Phone: ________________ E-Mail Address: <br />Name of Business: <br />Business Address: <br />Phone: ________________ <br />Business Structure: _____ Sole Proprietorship <br /> _____ Partnership (all partners must sign this <br /> application) <br /> _____ Corporation (list officers on separate sheet) <br />Type of Business (describe): <br />II. PROPERTY INFORMATION <br />Local Business or Non-Residential Real EstateProperty Owner: <br />Address: <br />Phone: ________________ E-Mail Address: <br />12 <br /> <br />