Report To Bureau Of Securities, Department Of Finance

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REPORT TO BUREAU OF SECURITIES, DEPARTMENT OF FINANCE
UNDER SECTION 50-2709, IDAHO CODE
The undersigned, ___________________________________________________
________________________________________________________________________
hereby certifies the following information:
1.
Issuer:
2.
Bonds issued:
3.
Date of issuance:
4.
Facilities constituting the project:
5.
Persons on behalf of whom the Issuer issued the bonds:
6.
The amount of permanent employment reasonably expected to be
created by the existence of the project:
DATED as of the ________ day of _______________________, _________.
By_________________________________
(Issuer)
APPROVED AND VERIFIED BY:
By_________________________________
(Beneficiary)
REPORT TO BUREAU OF SECURITIES

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