Ag/Commercial Loan Application

 

*Company Legal Name: *Federal Tax ID: DUNS #:
DBA: URL/Website: www.
Business Location: *Tel: Own Rent
City: State: Zip: Fax: Sq Footage:
*Mailing Address: *City: *State: *Zip:
*Primary Contact: *Title: *Email:
Decision Maker: Yes No Direct Tel: Cell Phone:
Company Information:
What does the company do? (Describe The Products And/Or Services
How will you Grow?
Acquisition/Merger
General Econ Growth
New Employees
New Market
New Product Line
Other
Year Business Established:
Current Owners: # of employees:
Full Time:
Part time:
Entity Type:
Non-Profit LLC
Sole Proprietorship LLC
General Partnership C-Corporation
Limited Partnership S Corporation
   
Industry:
Agricultural Retail
Business Wholesale
Manufacturing Other
Professional Services  
Other Locations:
How are the products sold?
Direct Mail
Inside Sales Force
Manufacturer Rep/Distributor
Outside Sales Force
Telemarketing
Other:
Is the business subject to a regulatory agency?
No
Yes
Did you have any government or international sales?
No  
 Yes    
Are sales seasonal?
No  
 Yes    
Have you been profitable for the past 3 years? Yes No
What is the status of the industry? How many customers do you have?
How are you trending this year? Who are your top three customers?
What are you doing to increase sales? Who buys your products or services?
Projected Sales this year $ Why do your customers buy from you?
What payment terms do you offer your customers? Any foreign customers? (If so, what % of sales?)
What percentage of sales do your top 3 customers represent? % Who is your competition?
How do you track your industry? How do you compete against them?
Management/Ownership Information
Owner:
Title:
Ownership:

%
Decision Maker: Yes No Industry Experience:yrs
Actively Involved: Yes No
Owner:
Title:
Ownership:

%
Decision Maker: Yes No Industry Experience:yrs
Actively Involved: Yes No
Owner:
Title:
Ownership:

%
Decision Maker: Yes No Industry Experience:yrs
Actively Involved: Yes No
Owner:
Title:
Ownership:

%
Decision Maker: Yes No Industry Experience:yrs
Actively Involved: Yes No
Owner:
Title:
Ownership:

%
Decision Maker: Yes No Industry Experience:yrs
Actively Involved: Yes No
Name of Bank:
Satisfaction Level:
High  
Avg.  
Low  
Current Outstanding Loans:
Line $
Loan $
Lease $
Real Estate $
Other
Deposit Needs:
Std Checking  
Analysis  
Sweep  
Money Market  
Branch Location:
What could your bank be doing for you?
What's important in your banking relationship?
Credit Request
Credit Line Amount:
Collateral:
Use of Funds:
Term Loan Amount:
Collateral:
Use of Funds:
Eq. Lease Amount:
Collateral:
Use of Funds:
Real Estate Amount:
Collateral:
Use of Funds:
Other Amount:
Collateral:
Use of Funds:
General Information
Do any of the owners listed on this application have an ownership, interest or continual liability in another company?
If yes, please provide owners name: Company: Ownership %:
Has the borrower used or done business under any other names? Yes No
Has the borrower, co-borrower, owner or guarantor ever been convicted of a felony? Yes No
Is the business an endorser, guarantor, or co-maker for obligations not listed on its financial statements? Yes No
Is the business a party to any claim or lawsuit? Yes No
Has the business ever declared bankruptcy? Yes No
Does the business use hazardous substance in the normal course of business? Yes No
Are any owners a Non-US. Citizen?
If yes, please provide name and indicate Residency Status:
Yes No
Is the applicant, or any officer, Principal or Partner of the applicant currently on the Board of Directors of a Bank, Thrift or S&L? Yes No
Please name the business CPA/Accountant: Tel:
May we contact the CPA/Accountant? Yes No  
Please name your personal CPA/Accountant: Tel:
May we contact the CPA/Accountant? Yes No  
Signatures
The foregoing statement, submitted for the purpose of obtaining credit, is true and correct in every detail and fairly shows my/our financial condition at the time indicated. I/we will give you prompt written notice of any subsequent substantial change in such financial condition occurring before discharge of my/our obligations to you. I/we understand that you will retain this personal financial statement whether or not you approve the credit in connection with which it is submitted. You are authorized to check my/our credit and employment history or any other information contained herein.
 
THE UNDERSIGNED CERTIFY THAT THE INFORMATION CONTAINED ON THIS FORM
HAS BEEN CAREFULLY REVIEWED AND THAT IT IS TRUE AND CORRECT IN ALL RESPECTS.
 
 

 *Date

 *Signature

 Date

 Signature