This application should be completed, and returned to Indiana Yearly Meeting Office, 4715 N. Wheeling Ave, Muncie, IN 47304. Phone: 765-284-6900, 800-292-5238.

Application Date________________Meeting's Tax ID Number_________________________

Monthly Mtg Name______________________Loan Amount Requested $_________________

Loan Purpose (Explain in detail, giving estimated costs of remodeling or improvements or new construction. Attach sketch of proposed improvement if applicable.)

1. Pastor's Name & Address____________________________________________________

_____________________________________________________________________________

Phone______________________E-mail________________________Full or Part-time_______________

2. Presiding Clerk's Name & Address_____________________________________________

______________________________________________________________________________________

Phone___________________E-mail_______________________________________________

3. Building Comm. Clerk's Name & Address_________________________________________

______________________________________________________________________________

Phone___________________E-mail_______________________________________________

4. Treasurer's Name & Address__________________________________________________

_____________________________________________________________________________

Phone___________________E-mail_______________________________________________

5. Trustees Clerk's Name & Address__________________________________________

_____________________________________________________________________________

Phone___________________E-mail________________________________________________

6. Membership: Number of Active Members (adult)_______________________
    Number of Associate Members (children)__________________

7. List the regular services held by your Meeting (Sunday School, Meeting for Worship,
Youth Groups, Mid-week Services, etc.)

9. Monthly Mtg date when the Loan Application for your project was approved___________________
(Please include a copy of Minute)

10. Is the Meeting united in this proposed expansion program?_________________________

11. Is the Meeting current in their assessment giving to Indiana Yearly Meeting?_________________

12. List all property, real and major personal, owned by the Meeting, giving a description of each
parcel of real estate.

________________________________________________________________________________

________________________________________________________________________________

_______________________________________________________________________________

13. Does the Meeting carry Public Liability and Property Damage Insurance? ______________

If so, how much? $__________________________________

14. Does the Meeting carry Workmen's Compensation Insurance?______________________

15. List all indebtedness of the Meeting:

To whom owed___________________________________________________________________

Purpose for debt_________________________________________________________________

Amount owed $___________________________Date originally incurred___________________

How and to whom secured (mortgage or personal guarantee)?__________________________

How payable?____________________________________________________________________

How much, if any, is past due?_____________________________________________________

16. Financial Report for last full fiscal year. Date year ended:____________________________________

(If a printed report, giving substantially the information requested below is available, a copy of such report may be attached in lieu of the following schedule.)

Receipts:

Total contributions from membership for regular budget $_________________________

Total contributions from membership for special purposes $_________________________

(Please itemize larger amounts:)

______________________________________ _______________________________________

_____________________________________ _______________________________________

Income from Endowments, Investments, or Trust Funds $_________________________

Other Income (itemize larger amounts) $_________________________

____________________________________ _________________________________________

____________________________________ __________________________________________

Other:______________________________________________ $_________________________

Total Receipts for all purposes: $_________________________

Total Expenditures: $_________________________

17. Total of Budget for current fiscal year $_________________________

18. Has an "Every-member Canvass" of the membership been made to provide the funds for this

budget?______If so, how much has been pledged?__________How many families have pledged?______

If no canvass has been made, what plans are being made to raise the needed funds?

_______________________________________________________________________________

________________________________________________________________________________

19. If any Endowment of Trust Funds are held by the Meeting or by any party for the Meeting's benefit, give brief list of such funds, and by whom held:

_________________________________________________________________________________________

________________________________________________________________________________

What are they for:________________________________________________________________

_______________________________________________________________________________

What do they do with them:_______________________________________________________

_______________________________________________________________________________

20. Explain in detail the Meeting's plans for raising funds for repayment of the loan requested:

_______________________________________________________________________________

_______________________________________________________________________________

21. Person to whom any communication regarding this application should be sent:

Name & Address_________________________________________________________________

_______________________________________________________________________________

Phone_____________________________ E-mail____________________________________

22. Signed on behalf of________________________________________________Monthly Meeting.

________________________________________ ______________________________________

(signature) (printed name)

Official capacity of person signing application:_______________________________________

Date:____________________________________