Form Sr-5 - Application For Registration Of Single Family Mortgage Revenue Bonds printable pdf download

Form Sr-5 - Application For Registration Of Single Family Mortgage Revenue Bonds

Jason Kander

Secretary of State

State of Missouri

Securities Division • 600 W. Main • PO Box 1276

Jefferson City, MO 65102

Application for Registration of Single Family Mortgage Revenue Bonds

Issued by Missouri Counties, Certain Cities, and the City of St. Louis

Pursuant to Sections 108.450 through 108.470 RSMo

INFORMATION WITH RESPECT TO THE ISSUER.

a. Name of Issuer: __________________________________________________________________________________________________

b. Address of Issuer: _________________________________________________________________________________________________

c. Form and date of organization of issuer: _______________________________________________________________________________

d. Name, address and position of all elected officials performing legislative functions for the issuer: ____________________________________

e. Name, address and position of chief elected executive officer of issuer: _______________________________________________________

___________________________________________________________________________________________________________________

f. Name, address and position of chief appointed fiscal officer of the issuer: _____________________________________________________

___________________________________________________________________________________________________________________

g. Do any of the officers or employees of the issuer named above have any material interest in any material transaction with the issuer or any

of its agencies as affected within the past three (3) years or proposed to be affected? _________________________________________ If

the answer is affirmative, please describe such interest or interests in a document attached hereto and marked Exhibit “A”.

INFORMATION WITH RESPECT TO THE BONDS.

a. Are the bonds being issued as those described in Sections 108.450 through 108.470 RSMo?

b. With respect to the bonds covered by this registration, state the amount of bonds being issued.

$ ____________________

c. Type of offering:

(1) Public sale ______________

(2) Negotiated sale ______________

(3) If the securities will have a proposed offering price, state the proposed maturity schedule and offering price per maturity or the method

by which it is to be computed in a document attached hereto and marked Exhibit “B”.

d. Will any portion of the bond issue be offered for sale by the Issuer to any person or class of persons other than underwriters? ___________

If so, specify any such person or class and variation in price from the price at which the offer will be made to underwriters and describe the

plan of distribution.

FORM SR-5 (07-13)

Form Sr-5 - Application For Registration Of Single Family Mortgage Revenue Bonds