Community Reinvestment Fund Application

Lake Shore Savings Community Reinvestment Fund has been established to provide funding for a wide variety of community organizations within the banks area of service. Please refer to the guidelines to determine your eligibility.

This application and a copy of the latest financial statement of your organization (if available) should be submitted to: Community Reinvestment Fund at any Lake Shore Savings branch office.

To download a .pdf file of this application, click here.
To download Adobe Acrobat Reader® for free, click here.

Deadlines: June 1, December 1

Name of Organization:

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Address:

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Telephone/Fax:

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What is the purpose of your organization? How many people do you serve each year?

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Name(s), title(s), and phone number(s) of individuals to be contacted relative to this application:

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Briefly describe the nature of the project for which you are requesting funds:

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What benefits would this provide to residents of this area?

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Approximately how many people would benefit from this program?

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What is the total cost of the project? (Please attach a breakdown of the project's costs.)

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Amount being requested from Community Reinvestment Fund:

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Do you have tax exempt status? ______ If yes, please include a copy of your I.R.S. approval letter.

Other information that may be helpful to the committee in assessing your application.

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Authorized Signature & Title		Date