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<br />For questions 35-39: Provide the following information for each recipient Jailing to fulfill goals or any other terms of an agreement that were <br />to be attained by the time ofre orting. (Attach additional a es i necessary.) <br />35. Information on recipient and agreement: <br /> <br />Name of recipient in default <br /> <br />Type of subsidy or assistance <br /> <br />Initial value of subsidy or assistance <br /> <br />Street address of recipient <br /> <br />City/Zip code of recipient <br /> <br />Outstanding value of subsidy <br />or assistance <br /> <br />36. ReasOli(s) for default (Mark all t11ft apply.): <br /> <br />CI recipient ceased operation <br /> <br />CI recipient relocated to a different community <br /> <br />CI recipient was unable to fill vacant positions <br /> <br />CI other (SpecifY reason.) <br /> <br />37. To date, has the recipient fulfilled its repayment obligation? (Markone.) <br /> <br />CI Yes <br /> <br />CI No, recipient has be~n to repay the assistance. <br /> <br />CI No, recipienthas not begun to repay the assistance. <br /> <br />38. Has the agreement been amended to extend the recipient's deadline for fulfilling its obligations? (Mark one.) <br /> <br />CI Yes <br /> <br />C1No <br /> <br />39. Describe the steps bemg taken to bring recipient into compliance or recoup the ~ubsidy: <br /> <br />Return your completed MBAF(s) by Mav 1. 2008 <br /> <br />EITHER <br /> <br />Mail To: <br /> <br />Minnesota Business Assistan<;;e Report <br />Minnesota Department of Employment and Economic Development- Analysis and Evaiuation <br />, . . I st Natio~al Bank Building <br />332 Minnesota Street, Suite .E200 <br />St. Paul, Minnesota 55101-1351 <br /> <br />OR <br /> <br />Fax To: <br /> <br />(651) 215-3841 <br /> <br />(Next year, please use the online version of this form. It can be found at <br />ww\v.deed.state.mn. us/Communitv/subsidiesIMBAFForm.htm.) <br /> <br />Minnesota Business Assistance Form (3/25/08) <br /> <br />Page 5 of5 <br /> <br />Dept. of EI:I1ployment and Economic Development <br />