Industrial Revenue Bond Informational Statement
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3BEFORE THE BOARD OF TAX APPEALS OF THE STATE OF KANSAS
Industrial Revenue Bond Informational Statement
(K.S.A. 12-1744a)
APPLICANT:
(
)
For State of Kansas use only
__________________________________________
City or County issuing I.R.B.s
__________________________________________
County in which City is located
Please answer all questions. If a question is not
applicable, please indicate (N/A).
IRB Statement No.________________-IRB
1.
Proposed lessee name and address
Fee:_____________
Amt Rec.__________
for whom bonds issued:
Rec. Date:________
Ck #______________
Guarantor for Bonds, if any:
Paying (Fiscal) Agent:
Underwriter, if any:
Attorney(s) who issued opinion:
Bond Counsel:
Tenant Counsel:
City Attorney:
Underwriter’s Counsel:
CTA-IRB (Rev. 7/14)
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