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CREDIT REQUESTED
Amount Requested Term of Credit Requested Loan Type: App. #
Line of Credit Business expansion
Specify all intended uses of Does borrower(s) have any Equipment purchase Furniture or Fixtures
loan proceeds (if more than unpaid taxes or judgments? Refinance (please specify) SBA
one): Yes No Other (please specify):
If yes, please explain:
Ownership Percentage Purpose of Credit Requested Credit Request Applicant Only
Joint with Co-Applicant(s) ______ ______
It is our intent to apply for joint credit initials initials
Main Contact Phone Number Filing Dates Filing Locations DBA Name
Please describe the nature of the business in which the borrower is engaged:
Principal Office Address (if not listed above) City State Zip Code
$ Purchase Money
Presently Owned
$ Purchase Money
Presently Owned
Use Additional Sheet if Necessary
1
RELATIONSHIP INFORMATION - APPLICANT'S HISTORY WITH LENDER
New Customer Customer Since (MM-YYYY): Last Financial Statement Date (MM-DD-YYYY):
Existing Customer
Last Tax Return Date on File (YYYY): Last Credit Report Date (MM-DD-YYYY):
Last Credit Bureau:
How Many Years in Business Any bankruptcies in last 10 years? Any current or pending law suits or judgments?
Yes No Yes No (If yes, please explain)
Liabilities with Lender Deposits with Lender Total Credit With Lender
Direct: $ DDA Avg: $ New Credit: $
Contingent: $ Other Avg: $ Proposed Total: $
Total: $ Total Avg: $
2
USE OF LOAN PROCEEDS
Please list all uses of which you plan to apply your proceeds. This is only necessary if not using the Lease Purchase
program and if the proceeds of the loan will be used for more than purposes outlined on the draw schedule that is
requested on the Commercial Financing Application Checklist. The Draw Schedule on its own, or combined with this
itemized list, should account for the total amount of funds requested on this application.
Purpose:___________________________ Amount:$_________________
Purpose:___________________________ Amount:$_________________
Purpose:___________________________ Amount:$_________________
Purpose:___________________________ Amount:$_________________
Purpose:___________________________ Amount:$_________________
Purpose:___________________________ Amount:$_________________