UW Treasury FAST Program Borrower Information Form

Submitter/Applicant Name

Submitter/Applicant NetID

Submitter/Applicant Email

Submitter/Applicant Title

Submitter/Applicant Phone Number

Submitter/Applicant school or department

Are you the person that we can contact for additional information regarding this loan application?

Yes

Applicant Name

Applicant NetID

Applicant Email

Applicant Title

Applicant Phone Number

Applicant school or department

Describe the asset; including manufacture and model number if applicable.

Please describe the organization that needs the loan

Has the asset already been purchased?

Yes

Date of the purchase,

Please indicate the desired loan amount

Please indicate the date the funds are needed

Can any available resource be used to purchase the asset?

Yes

Please provide additional details regarding the source and nature of the alternative financial resources, as well as any restrictions on their expenditure, and why a FAST loan would be preferable to using existing resources?

What is the source of the proposed repayment? Please provide details regarding the Worktags, Cost Center, Resource Tags, and Funds that will be used for repayment, the source of funds currently in that Cost Center, and the underlying activity generating the revenue for repayment

Upload any relevant documentation

One file only.
50 MB limit.
Allowed types: gif, jpg, jpeg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, mp4, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.

Please provide revenue and expense projections that demonstrate the ability to make debt repayments as well as ongoing maintenance and other fees associated with the asset?

Please describe your current outstanding indebtedness and future borrowing needs

What uncommitted reserves are available to repay the loan?

What approvals have you received or are needed to proceed? (Dean level approval and backstop will be required for loan access)

What additional information can you provide that may be relevant to this loan application?