General Information Form

General Information Form

For Ijara USA Commercial Application Form
Loan Request Information

Please complete all information to avoid delays in processing your application
Is this application for masjid/non-profit finance? *

Yes No
Application For *

Conventional Construction Finance SBA
Purpose of Loan *
Loan Type *

Purchase Refinance
Source of Repayment *
Amount Requested *
Term Requested in Years *
Please enter a number between 0 and 25
Amortization Requested in Years *
Please enter a number between 0 and 25
Term Requested in Years *
Please enter a number between 0 and 10
Amortization Requested in Years *
Please enter a number between 0 and 10

Loan Collateral

Subject Property
Type of Property *
Estimated Market Value *
Purchase Price *
Date of Purchase *

Month Day Year
Current Lender *
Rate *
Monthly Payment
Current Balance
Property Gross Annual Revenue *
Annual Expenses *
Number of Tenants *

Additional Property
Type of Property
Estimated Market Value
Purchase Price
Date of Purchase

Month Day Year
Current Lender
Rate
Monthly Payment
Current Balance
Property Gross Annual Revenue
Annual Expenses
Number of Tenants

Subject Property
Type of Property
Will purchaser occupy 51% or more of the property?

Yes No
Closing Date

Month Day Year
Purchase Price
Current Loans

Additional Property
Type of Property
Closing Date

Month Day Year
Purchase Price
Current Loans

Section Stopper
Do you have any additional properties?

Yes No

Owners Information

Upon submission of this form, all owners with 20% or more ownership will receive an email invitation to fill out our Personal Financial Statement form as part of the next step in this Commercial application.

Owner #1
Name *
First Name
Name *
Last Name
Percent Ownership *
Title *
Email *
This owner will receive an email invitation to fill out the Personal Financial Statement form.
Phone Number *

Owner #2
Name *
First Name
Name *
Last Name
Percent Ownership *
Title *
Email *
This owner will receive an email invitation to fill out the Personal Financial Statement form.
Phone Number *
Owner Percent Subtotal 2

Owner #3
Name *
First Name
Name *
Last Name
Percent Ownership *
Title *
Email *
This owner will receive an email invitation to fill out the Personal Financial Statement form.
Phone Number *
Owner Percent Subtotal 3

Owner #4
Name *
First Name
Name *
Last Name
Percent Ownership *
Title *
Email *
This owner will receive an email invitation to fill out the Personal Financial Statement form.
Phone Number *
Owner Percent Subtotal 4

Owner #5
Name *
First Name
Name *
Last Name
Percent Ownership *
Title *
Email *
This owner will receive an email invitation to fill out the Personal Financial Statement form.
Phone Number *
Owner Percent Subtotal 5

Owner #6
Name *
First Name
Name *
Last Name
Percent Ownership *
Title *
Email *
This owner will receive an email invitation to fill out the Personal Financial Statement form.
Phone Number *
Owner Percent Subtotal 6

Owner #7
Name *
First Name
Name *
Last Name
Percent Ownership *
Title *
Email *
This owner will receive an email invitation to fill out the Personal Financial Statement form.
Phone Number *
Owner Percent Subtotal 7

Owner #8
Name *
First Name
Name *
Last Name
Percent Ownership *
Title *
Email *
This owner will receive an email invitation to fill out the Personal Financial Statement form.
Phone Number *
Owner Percent Subtotal 8

Owner #9
Name *
First Name
Name *
Last Name
Percent Ownership *
Title *
Email *
This owner will receive an email invitation to fill out the Personal Financial Statement form.
Phone Number *
Owner Percent Subtotal 9

Owner #10
Name *
First Name
Name *
Last Name
Percent Ownership *
Title *
Email *
This owner will receive an email invitation to fill out the Personal Financial Statement form.
Phone Number *

Business Nature & History
Background and History of Business *
Include business to be acquired
Nature of Business, Types of Products/Services *
Customer Profile/List of Key Customers *
Marketing *
List of Major Competitors *
Major Past Accomplishments *
Future Expansion *
How will this loan benefit your business? *
For Start-Up Businesses or Acquisition of Existing Business

Attach a complete business plan and three years projections with the first year being month to month. Must also include explanations on projections, source, trends, etc.
Business plan and projections

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Cancel of

Loan Request
Real Estate/Building Acquisition
Land Acquisition
New Construction/Expansion/Repair
Acquisition and/or Repair of Machinery and Equipment
Inventory and Supplies Purchase
Working Capital
Acquisition of Existing Business
Refinance Loan
Miscellaneous Closing Fees
Miscellaneous Fees
Other
Describe
Other (Amount)
Amount of the previous item
Other (Continued)
Describe
Other (Continued, Amount)
Amount of the previous item
Other (Continued)
Describe
Other (Continued, Amount)
Amount of the previous item
Include a copy of proposed/executed purchase agreement and copies of all tenant leases if applicable

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Cancel of
List of Equipment to be Purchased
Total Estimated Project Amount
Subtotal of above amounts
Equity Injection *
Total Loan Requested
Total estimated project cost less applicant’s cash/equity injection
Source & explanation for cash/equity injection

Review

Loan Request Information

Is this application for masjid/non-profit finance?	{sec1_appForNP}

Application For	{sec1_appFor}

Purpose of Loan	{sec1_loanPurpose}
Loan Type	{sec1_loanType}
Source of Repayment	{sec1_repaymentSrc}
Amount Requested	$ {sec1_amtRequested}
Term Requested in Years	{sec1_termYears1}{sec1_termYears2}
Amortization Requested in Years	{sec1_amortYears1}{sec1_amortYears2}

Loan Collateral

Subject Property
Type of Property	{sec2_prop1_type}
Estimated Market Value	$ {sec2_prop1_mktVal}
Purchase Price	$ {sec2_prop1_purPrice}
Date of Purchase	{sec2_prop1_purDate}
Current Lender	{sec2_prop1_currLndr}
Rate	{sec2_prop1_rate} %
Monthly Payment	$ {sec2_prop1_mnthPmt}
Current Balance	$ {sec2_prop1_currBal}
Property Gross Annual Revenue	$ {sec2_prop1_annRev}
Annual Expenses	$ {sec2_prop1_annExp}
Number of Tenants	{sec2_prop1_tenants}

Additional Property
Type of Property	{sec2_prop2_type}
Estimated Market Value	$ {sec2_prop2_mktVal}
Purchase Price	$ {sec2_prop2_purPrice}
Date of Purchase	{sec2_prop2_purDate}
Current Lender	{sec2_prop2_currLndr}
Rate	{sec2_prop2_rate} %
Monthly Payment	$ {sec2_prop2_mnthPmt}
Current Balance	$ {sec2_prop2_currBal}
Property Gross Annual Revenue	$ {sec2_prop2_annRev}
Annual Expenses	$ {sec2_prop2_annExp}
Number of Tenants	{sec2_prop2_tenants}

Subject Property
Type of Property	{sec2_prop3_type}
Will purchaser occupy 51% or more of the property?	{sec2_prop3_majOwnOcc}
Closing Date	{sec2_prop3_closeDate}
Purchase Price	$ {sec2_prop3_purPrice}
Current Loans	$ {sec2_prop3_currLoans}

Additional Property
Type of Property	{sec2_prop4_type}
Closing Date	{sec2_prop4_closeDate}
Purchase Price	$ {sec2_prop4_purPrice}
Current Loans	$ {sec2_prop4_currLoans}

Do you have any additional properties?	{sec2_hasAddlProps}

Applicant Information

Legal Name of Applicant	{sec3_appFName} {sec3_appLName}

Applying Company	{sec3_appCompany}

Has your business been established yet?	{sec3_coEstablished}

DBA	{sec3_dba}
Principle Place of Business (Not P.O. Box)	{sec3_placeOfBiz}
Key Contact Name	{sec3_keyContFName} {sec3_keyContLName}
Business Phone Number	{sec3_bizPhone}
Mobile Number	{sec3_bizMobile}

Date Business Established	{sec3_bizEstDate}
Current Ownership	{sec3_currOwnYears}
State of Registration	{sec3_regState}
Annual Sales	$ {sec3_annSales}
Last Year’s Net Profit	$ {sec3_prevYearProfit}
Describe applicant’s product or service	{sec3_prodOrService}
Type of Entity	{sec3_entityType}
Number of Employees	{sec3_noEmployees}

Email	{sec3_email}
Who does applicant currently do their banking with?	{sec3_currBank}
Is applicant willing to move their banking relationship in conjunction with their loan?	{sec3_moveBankRel}

Owners Information

Owner #1
Name	{sec4_own1_fName} {sec4_own1_lName}
Percent Ownership	{sec4_own1_percOwn} %
Title	{sec4_own1_title}
Phone Number	{sec4_own1_phone}

Email	{sec4_own1_email}

Owner #2
Name	{sec4_own2_fName} {sec4_own2_lName}
Percent Ownership	{sec4_own2_percOwn} %
Title	{sec4_own2_title}
Phone Number	{sec4_own2_phone}

Email	{sec4_own2_email}

Owner #3
Name	{sec4_own3_fName} {sec4_own3_lName}
Percent Ownership	{sec4_own3_percOwn} %
Title	{sec4_own3_title}
Phone Number	{sec4_own3_phone}

Email	{sec4_own3_email}

Owner #4
Name	{sec4_own4_fName} {sec4_own4_lName}
Percent Ownership	{sec4_own4_percOwn} %
Title	{sec4_own4_title}
Phone Number	{sec4_own4_phone}

Email	{sec4_own4_email}

Owner #5
Name	{sec4_own5_fName} {sec4_own5_lName}
Percent Ownership	{sec4_own5_percOwn} %
Title	{sec4_own5_title}
Phone Number	{sec4_own5_phone}

Email	{sec4_own5_email}

Owner #6
Name	{sec4_own6_fName} {sec4_own6_lName}
Percent Ownership	{sec4_own6_percOwn} %
Title	{sec4_own6_title}
Phone Number	{sec4_own6_phone}

Email	{sec4_own6_email}

Owner #7
Name	{sec4_own7_fName} {sec4_own7_lName}
Percent Ownership	{sec4_own7_percOwn} %
Title	{sec4_own7_title}
Phone Number	{sec4_own7_phone}

Email	{sec4_own7_email}

Owner #8
Name	{sec4_own8_fName} {sec4_own8_lName}
Percent Ownership	{sec4_own8_percOwn} %
Title	{sec4_own8_title}
Phone Number	{sec4_own8_phone}

Email	{sec4_own8_email}

Owner #9
Name	{sec4_own9_fName} {sec4_own9_lName}
Percent Ownership	{sec4_own9_percOwn} %
Title	{sec4_own9_title}
Phone Number	{sec4_own9_phone}

Email	{sec4_own9_email}

Owner #10
Name	{sec4_own10_fName} {sec4_own10_lName}
Percent Ownership	{sec4_own10_percOwn} %
Title	{sec4_own10_title}
Phone Number	{sec4_own10_phone}

Email	{sec4_own10_email}

Disclosure Questions

Settlement Agent Name	{sec5_settlAgtName}
Settlement Agent Phone Number	{sec5_settlAgtPhone}
Insurance Company Phone Number	{sec5_insCoPhone}
Insurance Company Fax Number	{sec5_insCoFax}
Is the seller of the property willing to carry a second trust?	{sec5_seller2ndTrust}
Has the applicant ever declared bankruptcy or had any judgements, repossessions, garnishments, or other legal proceedings filed against them?	{sec5_applBankruptcy}
Is the applicant currently under contract with any other mortgage brokers?	{sec5_applUnderContract}
Are any tax obligations—including payroll or real estate taxes—past due?	{sec5_applPastDueTax}
Is the applicant liable on debts not shown, including any contingent liabilities such as leases, endorsements, guarantees, etc.?	{sec5_applDebtLiab}
Is the applicant currently a defendant in any suit or legal action?	{sec5_applDefendant}

Please provide an explanation for each question you answered “yes” to on this page.	{sec5_disclosureExpl}

Business Nature & History

Background and History of Business	{sec6_bizBackground}
Nature of Business, Types of Products/Services	{sec6_bizNature}
Customer Profile/List of Key Customers	{sec6_keyCustomers}
Marketing	{sec6_marketing}
List of Major Competitors	{sec6_competitors}
Major Past Accomplishments	{sec6_pastAccompl}
Future Expansion	{sec6_futureExpansion}
How will this loan benefit your business?	{sec6_loanBenefit}

For Start-Up Businesses or Acquisition of Existing Business
Business plan and projections	One or more files attached

Loan Request

Real Estate/Building Acquisition	$ {sec7_realEstate}
Land Acquisition	$ {sec7_landAcq}
New Construction/Expansion/Repair	$ {sec7_construction}
Acquisition and/or Repair of Machinery and Equipment	$ {sec7_machinery}
Inventory and Supplies Purchase	$ {sec7_inventory}
Working Capital	$ {sec7_wkngCapital}
Acquisition of Existing Business	$ {sec7_bizAcq}
Refinance Loan	$ {sec7_refLoan}
Miscellaneous Closing Fees	$ {sec7_miscClosing}
Miscellaneous Fees	$ {sec7_miscFees}

Include a copy of proposed/executed purchase agreement and copies of all tenant leases if applicable	One or more files attached

List of Equipment to be Purchased	{sec7_purEquip}
Total Estimated Project Amount	$ {sec7_ttlProjAmt}
Equity Injection	$ {sec7_eqInject}
Total Loan Requested	$ {sec7_loanTotal}
Comments & Explanation for cash/equity injection	{sec7_eqInjExpl}

Certification & Signature
Unless I initial here, the Lender/Broker is hereby authorized to share this application and credit information with its affiliates or other lenders, which may consider my/our application of loan approval/purchase. This statement does not limit the Lender/Broker’s rights to sell or assign any loans to a third party. Initial to opt out
Authorized Representative Full Name *

First Name Last Name
Authorized Representative Title *
Authorized Representative Signature: Signature*
Application Date

Year Month Day
Application Subcode *
Application Code *
Box Folder Name *
Should be Empty:

General Information Form

Loan Request Information

Loan Collateral

Applicant Information

Owners Information

Disclosure Questions

Business Nature & History

For Start-Up Businesses or Acquisition of Existing Business

Loan Request

Review

Certification & Signature