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<br />NOV <br /> <br />RECEIVED <br />92004 <br /> <br />CASS COUNTY COMMISSION <br /> <br />CASS COUNTY <br />MIDA BOND APPLICATION FORM <br /> <br />1. <br />2. <br /> <br />Name of applicant: American Lutheran Homes, Inc. <br /> <br />Telephone number of applicant: <br />239-3000 <br /> <br />3. <br /> <br />Size of issue requested: <br /> <br />$4,700,000 <br /> <br />4. <br /> <br />Type of issue (check one): <br />(a) Small issue - $1,000,000 [Section I44(a)] <br />(b) Small issue - $10,000,000 [Section I44(a)(4)] <br />(c) Qualified residential rental project [Section l42(a)(7)] <br />(d) Qualified 50I(c)(3) issue [Section 145] <br />(e) X Refunding issue <br />(f) Other (specify type): <br /> <br />If type of issue checked was small issue ($1,000,000 or $10,000,000), is issue for a manufacturing facility <br />as defined in Section I44(a)(I2)(C)? Yes No <br /> <br />5. <br /> <br />6. <br /> <br />Iftype of issue check was qualified residential rental project, will project meet the low income requirements <br />for tenants as set out in Section I42(d)? Yes No <br /> <br />7. <br /> <br />Estimated date of issue if approved by County: December 15, 2004 <br /> <br />8. <br /> <br />Give a brief explanation of project, which explanation should include the location of the project, description <br />of the use of the bond proceeds, and whether or not the project would create additional employment: <br /> <br />9. <br /> <br />Bond proceeds will be used to refund the following outstanding bonds issued by Cass County: <br />(i) Nursing Facility Revenue Bonds (American Lutheran Homes, Inc. Project) Series 1996A; <br />(ii) Nursing Facility Refunding Revenue Bonds (American Lutheran Homes, Inc. Project) Series <br />1998; <br />Health Care Facilities Revenue Bonds (American Lutheran Homes, Inc. Towers II Project) <br />Series 1998; and <br />Congregate Housing Revenue Bonds (American Lutheran Homes, Inc. Kinder Apartments <br />Project) Series 2001. <br /> <br />Attached to the Application Form is a check in the amount of$I ,000 which is the application fee, which fee <br />is nonrefundable. If issue does close, the application fee shall be deducted from the issuance fee set out in <br />paragraph 11. <br /> <br />(iii) <br />(iv) <br /> <br />10. <br /> <br />Attached is a typed Initial Resolution giving project preliminary approval in substantially the form provided <br />by the County Auditor's office. The Initial Resolution shall be placed on the County Commission agenda <br />for a meeting determined by the County Auditor's office. No public hearing is required for refunding bonds. <br /> <br />The applicant understands that the issuance fee for a new MIDA bond issue is equal to 1 % of the first <br />$1,000,000 of the Bond issue and that there is no fee beyond the first $1,000,000. For refunding bond issues <br />the issuance fee is one-half of the amount set forth above. <br /> <br />II. <br /> <br />Dated: November 8, 2004. <br /> <br />American Lutheran Homes, Inc. <br /> <br />By: <br /> <br />