Financing Request

The Responses to This Form Will Assist with Introducing Your Project to Capital Providers

Please fill out this form once you have entered into an engagement with PFA

Please respond as completely as possible

The more complete your response, the more likely we will be able to help you

and the more quickly we can introduce you to a capital provider

Write N/A if a request is not applicable

This form is divided into the following sections:

Tax Credits / Contracts | Authorized Officer | Parent Company (if applicable)

Project Company

Name of Project Company

Type of Entity

State / Country of Incorporation

Street Address

City

State / Province

Zip Code / Postal Code

Country

Project Overview

Name of Project

Project Type (indicate whether an acquisition, new development, renovation, or expansion; indicate whether residential, commercial, industrial, or healthcare; indicate type of project: senior living, multi-family, oil & gas, data center, etc.)

Brief Project Description (up to 500 words). Be sure to highlight the project's value proposition. You also can upload an executive summary or pitch deck using the Project Description upload button below (if you do this, please write "see attachment")

Project Description, Executive Summary, or Pitch Deck

Key Project Highlights (please provide 8-10 bullet points that summarize the project's value proposition and its key features; i.e., what are the 8-10 reasons a capital provider should be interested in your project?

Project Location (If in the U.S., full address, city, county, state and zip code. If outside the U.S., full address, city, province or equivalent, postal code, and country). If there is no street address, please provide latitude and longitude.

Current Status

Project Status (if it is vacant land, indicate whether it is a greenfield or brownfield site; please indicate whether it is shovel ready, under development, or in its planning stages; indicate if it will use an emerging technology or process)

Site Status (indicate whether owned outright or percentage of ownership percentage; whether owned by other entities or individuals; if pledged as collateral, or subject to a mortgage or lien; whether under option, LOI or MOU, under contract, or leased)

Status of Permits (fully permitted, permitting underway, some permits approved some pending, permitting application process initiated, or permitting has yet to be done)

Project Timeline (projected start and end dates; projected timelines for site control, permitting, site preparation, start of construction / renovation / expansion, date of completion, start of operations / productions / services, etc.)

Financing Request

Total Project Cost

Amount of Financing Requested

Type of Financing Requested (debt, equity, debt+equity, bridge loan, refinance, development capital, venture capital, etc., please specify)

Use of Funds Summary (you also can attach a Source & Uses table by using the Sources & Uses upload button below; if you do so, please write "see attachment")

Sources & Uses Table

Other Financial Information (optional)

Collateral (if requesting a loan) - type and value

Equity

Money Spent to Date

Current Equity in Project

Amount of Equity Held by Project Developer

Amount of Equity Held by Others

Is There a Willingness / Capacity to Provide Additional Equity if Required?

Yes

Are Funds Available for Underwriting and Legal Fees?

Yes

Explanation, if necessary

Debt / EBIDTA / IRR

Is There Existing Debt on the Company or Project? (If so, please provide details of the debt: name of lender, amount, and term of loan)

Debt Details

Projected EBIDTA - Years 1, 3, 5 and 10

Projected IRR

Tax Credits / Contracts

Tax Credits (investment, production, accelerated depreciation, Opportunity / Enterprise Zone, New Market, and local property, sales, and use tax credits, abatements, exemptions, and hiring bonuses)

Other Credits (carbon offsets, Renewable Identification Numbers / RINs, Low Carbon Fuel Standard / LCFS)

Status of Contracts (raw material / feedstock supply; product offtakes / sales; Power Purchase Agreements; contracts with EPC and O&M firms; etc.

Terms and Duration of Each Contract (indicate if currently a LOI or MOU)

Authorized Officer

Who will be the principle contact for capital providers with signing authority for the project?

First Name (and initial)

Last Name

Suffix ( including MD, PhD, JD, PE, CPA, etc.)

Position / Title

Company Name

Street Address

City

State or Province

Zip Code / Postal Code

Country

Authorized Officer's Email

Company Website

Country Code

Telephone Number

Extension

Parent Company

if applicable

Parent Company Name

Street Address

City

State / Province

Zip Code / Postal Code

Country

Website

Country Code

Telephone

Thank you for taking the time to fill out this form. This information will help capital providers better assess your project and consider it for financing

If you click the submit button and it does not respond, check to be sure you have filled in all required fields (with a *)

Project Overview

Current Status

Financing Request

Equity

Current Status

Financing Request

Project Company

Equity

Debt / EBIDTA / IRR

Project Overview

Project Company

Debt EBIDTA IRR

Tax Credits - Contracts

Tax Credits / Contracts

Authorized Officer

Parent Company
(if applicable)

Parent Company

Project Financing Assistance

An American Diversified Enterprises company

Financing Request

Project Company

Project Overview

Current Status

Financing Request

Equity

Debt / EBIDTA / IRR

Tax Credits / Contracts

Authorized Officer

Parent Company

Current Status

Financing Request

Project Company

Equity

Debt / EBIDTA / IRR

Project Overview

Tax Credits / Contracts

Authorized Officer

Parent Company
(if applicable)

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