Business Loan Application Form
Business Legal Name
*
Other Trade or Doing Business As Name
Select Business Type:
*
Sole Proprietorship
Corporation
Limited Liability Company
General Partnership
Limited Liability Partnership
Limited Partnership
Branch Location
*
Rochester
Red Wing
First & Last Name
*
Prefix
First Name
Last Name
Suffix
Phone Number
*
-
Area Code
Phone Number
Best time to contact you
*
Morning
Afternoon
Evening
Birth Date
*
-
Month
-
Day
Year
Date
Email
*
example@example.com
Marital Status
*
UnMarried
Married
Separated
Amount of Loan Requested
*
Have you ever had a loan the same or similar to what you are applying for?
*
Number of Employees
*
Business Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
If mailing address is different from business address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Business Phone Number
*
-
Area Code
Phone Number
Tax ID/EIN Number
*
Gross Annual Sales
*
Gross Income
*
Total Business Checking Account Balance
*
State of Registration
*
Date of Business Established
*
NAICIS Code
*
Are you a US Citizen?
*
Yes
No
Are you a current customer with us?
*
Yes
No
Who do you currently bank with (skip if you checked yes to the above question)?
If not, how did you hear about us?
Internet/Web
Newspaper
Friend/Relative
Radio
Estimated Credit Score
*
Social Security Number
*
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Time at Residence
Years
Months
Previous Address (if less than 2 years at current address)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Do you currently own or rent your home?
*
Rent
Own
Monthly Mortgage/Rent
*
Employment Information
Current Employer
*
Job Title
*
Work Address (if different from 'Business Address listed above)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Work Phone Number
*
-
Area Code
Phone Number
Annual Gross Income
*
in USD
Length of Employment
Years
Months
Have you ever filed for Bankruptcy?
*
Yes
No
If yes, what was the year of discharge?
Additional Comments
Everything that I have stated in this application is correct to the best of my knowledge. I understand that you will retain this application whether or not loan is approved. You are authorized to check my credit and employment history and to answer questions about your credit experience with me.
*
Applicant's Signature
Clear
Submit
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