Instructions: This form must be completed, signed and submitted along with required attachments to Minnesota Housing prior to receiving a disbursement of funds. To complete the form, enter the amount of funds you are requesting. The form must be signed by an authorized representative. Once signed, submit the completed form by emailing to mhfa.rrdl@state.mn.us. 

Disbursement Request and Justification
Amount requested:      
RRDL funds are disbursed in three installments. This disbursement is for:
•	Closing
•	50% Construction Completion
•	Construction Completion
Progress report (to be completed by architect):
•	Scope of work items completed:
     

•	Scope of work items remaining:
     

•	Remaining project timeline:				(Not applicable at Project Closeout)
     

•	Estimated project completion date: 			(Not applicable at Project Closeout)
     

Required Attachments
•	Photos of completed work and work in progress

•	Proof of payment (invoices and cancelled checks) for expenses paid from previous draw

Authorized Representative Signature

Authorized Representative Name: 	     	

Authorized Representative Title:	     	

Date Signed:	     	

Authorized Representative Signature: