1. Request for Allocation of Qualified School Construction Bonds

North Dakota Department of Public Instruction
School Finance and Organization

* 1. Please enter your contact information

* 2. *NOTE* If the request is for $150,000 or more, you will also need to submit a Facility Plan to the School Finance and Organization Unit in DPI

In accordance with the provisions of federal laws and regulations governing Qualified School Construction Bonds (QSCB), request is hereby made for an allocation of such QSCB in the amount of

(enter amount requested):

* 3. QSCB allocation being used for:

* 4. District Bond Counsel/Financial Advisor - Name:

* 5. District Bond Counsel/Financial Advisor - Phone Number: