EmailMeForm
New Mexico FUNDIT
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Submission Date:
MM
/
DD
/
YYYY
Project Name
Project Description
Applicant/entity’s Address
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Entity Type:
Identify the owner of the project
Project’s Location (if different than applicant)
Street Address
City
State / Province / Region
Postal / Zip Code
Project Purpose:
Project Type
Please select
New
Replace Existing
Renovate/Repair
Category
Please select
Infrastructure
Economic Development
Renovate/Repair
Housing Development
Business Development
Community Development
Downtown Revitalization
Housing Development
Other
Total Project Estimated Cost
$
Dollars
.
Cents
Total Amount Secured So Far
$
Dollars
.
Cents
Total Gap
$
Dollars
.
Cents
Anticipated Start Date:
MM
/
DD
/
YYYY
Anticipated End Date:
MM
/
DD
/
YYYY
Contact Name
First
Last
Organization
Phone
###
-
###
-
####
Email
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2
