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NMTC Intake Form

This form is provided by FirstPathway Community Development (FPCD) for applicants to apply for New Market Tax Credits (NMTC) allocation.  This application will be used by FPCD to determine if an applicant:

  • Meets the minimum NMTC program requirements
  • Meets the terms of FPCD Allocation Agreement
  • Maximizes value of NMTC financing in community impact

Please keep in mind that FPCD will use information provided on your application to determine:

  • The necessity of NMTC financing in project underwriting
  • Whether the amount of the NMTC allocation is appropriate

Additional due diligence information may be required to confirm statements made in the application.

Please visit for more information regarding the NMTC Program.

General Information

(If multiple addresses are involved please submit a separate listing of all addresses and associated census tracts.)

1. Information can be found at
2.  5 digit code, first two numbers is the state code, then county code,;

Project Specific Information

Community Profile

Is your business located in any of the following?

Qualified Low Income Community Business Information

Please answer the following questions for the QALICB.

Financial Profile/Sources

(net of fees)

Type: Debt, Grant, Equity, other tax credits, etc.

Status (attach copies of any letters that apply):

Disbursed- Funds have been given to the borrower and distributed for use,

Commitment Letter-The borrower has received a legally binding commitment from the lender.

Term Sheet- Financing contingent on approval and verification of assumptions.  The lender is not legally bound.

Committee, Board or Public Approvals- The borrower has received approval for private or public additional funding.

Application Pending- Borrower has submitted application for funding but has not received a decision by time of this writing.

Estimate- An informal, preliminary estimate of available funds.

Other- Please explain.

Contact Information

I hereby attest that all information furnished herein as part of this application is true and accurate to the best of my knowledge.

Please submit the following:

  • Application
  • Pro Forma development budget and/or operating budget
  • Resumes for management or development team
  • 3 year financial statements of operating business or developer and managing general partner

Submit Completed Forms and supporting information to John Widmer

This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

How can we be helpful?

Call 888-560-3688 x223 or email us here email to contact our office directly.

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