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pP^Community Invcstmcnt Tax Credit Program for the Promotion of Affordablc Housing Opportunities CERTIFICATE OF CONTRIBUTION FOR TAX CREDIT

PART I - BUSINESS AND CONTRIBUTION INFORMATION (Completed by Contributor)

Name of financial institutięn: I Business mailing address

Contact person and titlc: 1_

Tennessee Franchise and Excisc number: L Tax Ycar (Check One)    l^flj Calcndar year

Fiscal ycar from I

Type of lnvestment (Check Ali That Apply):

BQualified loan (2% below prime ratę)    $

lBQualified low-rate loan (4% below prime ratę) $ 2jQualiłled investment (longer than 5 years) S 55 Ci rant or contri bulion    S

Submitted by:L

By:

■	rexl1-0?	■
■i	rcxti-ic	■
ii	Toxt1-11 Toxl1-12

Datę Approved

	Text1-13
■■	Tcxl1 -14	WM
■■	Tex11-15
■■	Text1-16

Name of Financial Institution

M ALL PC World

Signature

Print Name and Titlc

Dale

PART 2 - F.1.IGIB1.F. HOUSING ORGANIZATION (Completed by Eligible Organization) (Check One)

Bi Tennessee Nonprofit Organization    9 Public Housing Authority

15 Development District    0! TH DA

..........    . I    ~1——