Commercial Loan Application

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Name
Social Security Number
DOB
Driver's License
Expiration Date
State
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:
High
Avg.
Low
Current Outstanding Loans:
Line $
Loan $
Lease $
Real Estate $
Other
Deposit Needs:
Std Checking
Analysis
Swoop
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
Does the borrower hold any assets to user? 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: Tel:
May we contact the CPA? Yes No  
Please name your personal CPA: Tel:
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 the Bank ("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 and further information the bank may require to process this application
X
Signer

Date
X
Signer

Date