APPLICATION FOR UNSECURED BUSINESS LINE OF CREDIT

Broker
Company Name
Application Submitted by*
 Phone*
Loan Amount
 Purpose of the loan?

 

Business Information
Business Name
 Doing Business As
Address
  
Phone
 Fax
 Email*
City                             State                           Zip Code
Country
 TAX ID/S.S.Number
 No of Employees
Nature of Business or SIC
 Year Established
 State of Organization
 Annual Sales Revenue
$ 		Annual Net Profit
$
Type of Organization
 
C-Corp S.Corp Sole Prop. LLC Limited Part. General Part LLP Other

 

Other information
Are you a US Citizen
Yes No 		Length of time you have owned the business                     
Date of business was started
 Is your place of business leased or owned
Leased Owned
Monthly payment
 Value
Date of Incorporation
Who do you do your business banking with
 12 month Avg. balance
 Current A/C balance
Who do you do your personal banking with
 12 month Avg.balance
 Current A/C balance
Depreciation expense
 Interest expense
 Additional household income
Have you applied for credit in last 60 days
Yes No
Do not apply for credit elsewhere as it may result in applications being denied by the bank.


 
Management information (The personal guaranty of the owner(s) is required. Use additional applications if necessary)
Owner 1
Owner 2
Name
 Date of Birth
Name
 Date of Birth
Title
 % Owner
 # Years Owned
Title
 % Owner
 # Years Owned
Home address
 Years at Address
Home address
 Years at Address
City          State         Zip Code
 Home Phone
City                     State                   Zip Code
 Home Phone
Drivers License Number
 State
Drivers License Number
 State
Issue Date
 Expiration Date
Issue Date
 Expiration Date
Social Security No
 Monthly Mortgage & Taxes/Rents
Social Security No
 Monthly Mortgage & Taxes/Rents
Note: Attorney , child support or separate maintenance income need not be disclosed if you do not choose to have it considered as a basis for repaying this loan. Note: Attorney , child support or separate maintenance income need not be disclosed if you do not choose to have it considered as a basis for repaying this loan.
Adjusted gross income as reported on Federal Tax Returns.
$ Year
Adjusted gross income as reported on Federal Tax Returns.
$ Year
Asset Ownership : J = Joint         A = Applicant only (Please provide name below if jointly owned)
Personal Assets
J/A
Personal Liabilities
J/A
Liquid Assets Personal Mortgage Bal.
Retirement Assets Home Equity Balance
Personal Residence Installment Balance
Investment Real Estate Credit Card Balances
Networth of Business Owned Contingent Liabilities
Other Assets Other Debts
Total Assets Total Liabilities
Net Worth (Tot assets-Tot Liabilities)
Personal Assets
J/A
Personal Liabilities
J/A
Liquid Assets Personal Mortgage Bal.
Retirement Assets Home Equity Balance
Personal Residence Installment Balance
Investment Real Estate Credit Card Balances
Networth of Business Owned Contingent Liabilities
Other Assets Other Debts
Total Assets Total Liabilities
Net Worth (Tot assets-Tot Liabilities)
Please answer the following
Yes
No
Have you ever declared bankruptcy?
Do you have any law suits pending against you?
Do you have any taxes that are past due?
Have you ever defaulted a loan?
Do you have any other credit application pending?
Does your business have unsecured credit at other institutions?
Dollar amount of line / loan
$ 		Name of institution
Please answer the following
Yes
No
Have you ever declared bankruptcy?
Do you have any law suits pending against you?
Do you have any taxes that are past due?
Have you ever defaulted a loan?
Do you have any other credit application pending?
Does your business have unsecured credit at other institutions?
Dollar amount of line / loan
$ 		Name of institution
If you answered yes to any of the above questions or have checked jointly owned, please describe.
 If you answered yes to any of the above questions or have checked jointly owned, please describe.
When completed, please click on "Submit" below