Form Sfn 59686 - Business Incentive Agreement - North Dakota Department Of Commerce Page 4

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SFN 59686 (04/2012)
Page 4
ATTACHMENT “A”
RECIPIENT verifies it has received additional financial assistance from state or political subdivision GRANTORS from the following
listed entities for this project since its inception. A listing of incentives from past projects (i.e. past expansions) is not required.
GRANTOR
On Behalf Of
Benefit/Pending Benefit Date
Value of Assistance
Type of Incentive
Description of Assistance
GRANTOR
On Behalf Of
Benefit/Pending Benefit Date
Value of Assistance
Type of Incentive
Description of Assistance
GRANTOR
On Behalf Of
Benefit/Pending Benefit Date
Value of Assistance
Type of Incentive
Description of Assistance
GRANTOR
On Behalf Of
Benefit/Pending Benefit Date
Value of Assistance
Type of Incentive
Description of Assistance
GRANTOR
On Behalf Of
Benefit/Pending Benefit Date
Value of Assistance
Type of Incentive
Description of Assistance

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