First Bank and Trust
Commercial Loan Application    
     
Purpose of Loan    
Company Legal Name Federal Tax ID DUNS #
DBA URL/Website: www.
Street Address Phone Own Rent
City State Zip Fax Sq Footage
Mailing Address: City State Zip
Primary Contact: Title Email
Decision Maker Yes No Direct Phone 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
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 Title
Ownership

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

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

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

%
Decision Maker Yes No Industry Experience yrs
Actively Involved Yes No
Name of Bank
Satisfaction
High
Avg
Low
Current Outstanding Loans
Line $
Loan $
Lease $
Real Estate $
Other
Deposit Needs
Standard 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 owner's name Company Ownership %
Has the borrower used or done business under any other names? Yes No
Does the borrower hold any assets to use? 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 Phone
May we contact the CPA? Yes No  
Please name your personal CPA Phone
May we contact the CPA? Yes No  
Signatures
The signer(s) certify that the above statement and attached supporting schedules, including all financial statements and tax returns, prepared by or for the undersigned are a complete and true statement of the financial condition of the undersigned on the dated indicated.  The signer(s) authorizes First Bank and Trust ("Bank") to obtain consumer and/or business reports in their names as individuals at any time and to verify all portions of this financial statement, including all financial statements and federal tax returns, with appropriate sources. The Bank is also authorized to provide credit information about the signer(s) to other creditors and credit reporting agencies. The signer(s) also agree to provide further information the bank may require to process this application.

Click Here to certify that you agree to the terms above
X
Signer

Date
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Signer

Date

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