Online Business Loan Application

* Required Fields

General

Have you spoken with a Business Banking Officer at CNB?

Yes
No
If so, please provide the officer's name

Please select your preferred Citizens National Bank Office

Business Information

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How are you applying for this business loan?

Individual
Business Entity

Legal Business Name Doing Business As (DBA) Name Tax ID Years in Business Business Type Industry Type Street Address City State Zip Code Total Business Assets Total Business Liabilities Annual Business Debt Payments Annual Business Revenue Annual Business Net Income

Ownership Information

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Borrower/Guarantor

First Name Middle Initial Last Name Birth Date Social Security Number Street Address City State Zip Code

Are you a US citizen or lawful permanent resident?

Are you the primary contact?

Is this a trust?

Business Title % of Business Ownership Business Phone Number E-mail Address Total Assets Total Liabilities Annual Debt Payments Annual Income

 Add Another Borrower/Guarantor

NOTE: ANY PERSON WHO OWNS 20% OR MORE OF THIS BUSINESS NEEDS INCLUDED IN THIS SECTION AS A BORROWER/GUARANTOR.

Loan Request Information

NOTE: IF YOU DO NOT HAVE THE INFORMATION REQUESTED BELOW BUT WOULD LIKE TO BE CONTACTED BY A LENDER, ENTER "0" INTO THE FIELDS BELOW.

Amount Requested

Type of Loan Requested

NOTE: TO APPLY FOR A VISA CREDIT CARD, YOU MUST BE A CURRENT CUSTOMER WITH CITIZENS NATIONAL BANK.

Visa® Credit Card
Equipment Loan
Operating Loan
Real Estate Loan
1-4 Family Residential Dwelling
Other

Describe Purpose of the Loan

Visa® Credit Card Signers

NOTE: IF VISA® BUSINESS CREDIT CARD AGREEMENT SIGNERS DIFFER FROM THE OWNERS LISTED ABOVE, FILL IN THE FIELDS BELOW AS APPLICABLE FOR ALL INTENDED SIGNERS.

Card Signer

First Name Middle Initial Last Name Birth Date Social Security Number Street Address City State Zip Code Business Title E-mail Address

 Add Another Signer

Acknowledgement

I hereby certify that all these statements are true and correct, and I authorize you to obtain such information as may be required concerning the statements made in this application. I agree this application shall irrevocably remain the property of the bank. The Ohio Law against discrimination require that all creditors make credit available to all creditworthy customers and that credit reporting agencies maintain separate credit histories on each individual upon request. The "Ohio Civil Rights Commission" administers compliance with this law. In addition, each individual signing below authorizes the creditor to check their individual credit accounts, employment history, and have a credit reporting agency prepare for a credit report on them. "ALL PARTIES SIGNING THE APPLICATION ARE AFFIRMING THEIR INTENT TO APPLY FOR JOINT CREDIT. A SINGLE SIGNATURE IMPLIES INTENT FOR INDIVIDUAL CREDIT."

I (We) apply for a Visa® card or cards and hereby request that a card or cards and related Personal Identification Number be issued to me (us). In consideration of the issuance of such card(s), I (we) agree to be bound by the terms of the Business Credit Card Agreement and any terms and conditions delivered upon approval of such card(s) as they may be revised from time to time. If more than one person signs this application and agreement, such person will be liable jointly and severally on all Visa® account and, in the event of the issuance of such card(s), each person will be deemed to be a Visa® "cardholder" and to authorize the other person(s) to use such card(s). I (we) certify that the information provided above is true and accurate to the best of my (our) knowledge and authorize the issuer to obtain any credit information concerning me (us) that it requires in connection with this application. By signing below, I acknowledge receipt of the Visa® credit card agreement disclosure and agree to the terms. Business Visa® Credit Card Agreement Disclosure

"I (We) have read the Electronic Records Consent and consent to the electronic delivery of required documents. The Electronic Records Consent will be sent to the email address entered as the primary contact for the business.

Type your name in the box below to represent your electronic signature.

Borrower/Guarantor Signature Date

Need help with the application or have questions? Give us a call at 1(800) 262-4663.