An authority may require any request for private activity bond financing when submitted to the authority to be accompanied by a statement in the following form, but the absence of any such form shall not affect the validity of a private activity bond:
________________
Date
_________________
(Name of Applicant)
_________________
(Facility)
a1. Maximum amount of financing sought$____
b2. Estimated taxable value of the facility’s real property to be constructed in the locality$____
c3. Estimated real property tax per year using present tax rates$____
d4. Estimated personal property tax per year using present tax rates$____
e5. Estimated merchants’ capital tax per year using present tax rates$____
f6. a. Estimated dollar value per year of goods that will be purchased from Virginia companies within the locality$____
gb. Estimated dollar value per year of goods that will be purchased from non-Virginia companies within the locality$____
hc. Estimated dollar value per year of services that will be purchased from Virginia companies within the locality$____
id. Estimated dollar value per year of services that will be purchased from non-Virginia companies within the locality$____
j7. Estimated number of regular employees on year round basis$____
k8. Average annual salary per employee$____
Signature
____________________
Authority Chairman
_____________________
Name of Authority
If one or more of the above questions do not apply to the facility indicate by writing N/A (not applicable) on the appropriate line.
The provisions of this section shall not apply to bonds, notes or other obligations issued pursuant to hearings held and governmental approvals obtained prior to the effective date of this act in compliance with federal law or regulation.