STATE OF MISSISSIPPI

DEVELOPMENT INFRASTRUCTURE PROGRAM

Pre-Application

Applicant:

COMMUNITY SERVICES DIVISION

MISSISSIPPI DEVELOPMENT AUTHORITY

501 North West Street ■ Post Office Box 849 ■ Jackson, Mississippi 39205-0849

Telephone (601) 359-3179

MISSISSIPPI DEVELOPMENT INFRASTRUCTURE PROGRAM (DIP)

ECONOMIC DEVELOPMENT PROPOSAL FORM

Applicant Information / Name of Municipality or County
Address
Phone Number
Mayor/President of Supervisors Name
Name of Benefitting Business
Type of Improvements
Water Sewer Access Road Purchase/Acquisition
Building Other:
Briefly explain the project
Proposed Budget / DIP / $0.00
Local (10% Minimum)
Company Investment
Other
Total / $0.00
Number of Jobs / Current Number of Jobs / To be created
Name and telephone number of contact person to discuss the proposal.
Date:
Please Note: All forms must be filled out and attachments must be submitted for the Pre-Application to be complete. MDA will not accept an incomplete Pre-Application.
MISSISSIPPI DEVELOPMENT INFRASTRUCTURE PROGRAM (DIP)

Attachments

Provide the following as attachments to the pre- application:
Cost Estimates: Include a general cost estimate. Cost estimate must be submitted by an engineer or architect on their letterhead as a signed and stamped original.
Detailed Map showing location of proposed project. Maps must explicitly correspond to the proposed scope of activities within this project.
Budget Sheet
Benefitting Business Information Packet
Financial Information as detailed in the Benefitting Business Information Packet
Submit one (1) original of the pre-application to MDA. Complete pre-applications must be submitted with
BOTTOM TABBED DIVIDERS IN BETWEEN EACH ATTACHMENT. All documentation should have
original signatures. MDA will evaluate the pre-application to determine if the project meets program criteria. MDA will issue a letter inviting a full application once the pre-application is complete, a financial review of the benefitting business has been conducted and found to be in sound financial condition, and funds are available.
Pre-Applications can be mailed to:
Mississippi Development Infrastructure Program
Mississippi Development Authority
Community Services Division
Post Office Box 849
Jackson, Mississippi 39205