CEDF NONPROFIT LOAN APPLICATION

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NONPROFIT LOAN APPLICATION

This application is one component of several required submissions. Refer to the checklist provided.
Need help?

If you need help with any part of this submission, please feel free to contact CEDF during regular business hours at (203) 235-2333 x2001 or lending@CEDF.com. You may save and complete your entries for later submission. Save button is at the bottom of the form.
Amount Requested $
Purpose of the Loan
Collateral Description
Tax Exempt Status
Organization Type
Legally Registered Company Name
Trade or DBA Name
Acronym if any
Primary Contact
Title
Physical Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone
Email
example@example.com
Cell Phone
Website
Fax
Mission statement:
Date Established

MonthDayYear
Date
Federal Tax ID
Referred By
Primary Bank Name
Gross Annual Revenue $
Total Organizational Debt $
No. of Current Full Time Employees
No. of Current Part Time Employees
No. of Projected Full Time Employees in one year based on successful funding
No. of Projected Part Time Employees in one year based on successful funding
Executive / Senior Leadership Team*
Project Sources and Use of Funds
Where will you get the money?*
How will you spend the money?*
Business Financial Data Provided Below is as of:

MonthDayYear
Date
Assets (Show each applicable type. Show total in last row.)*
Liabilities (Show each applicable type. Show total in last row.)*
Net Assets
Income / Expenses (Show for each line item. Show Net Income in last row.)*
Existing Business Debt (Please list all creditors)*
Agreement to Apply

THE UNDERSIGNED CERTIFIES THAT THE INFORMATION PROVIDED HAS BEEN CAREFULLY READ AND IS TRUE, CORRECT AND COMPLETE. THE UNDERSIGNED FURTHER REPRESENTS THAT THERE ARE NOT ENCUMBRANCES AGAINST ANY OF THE FOREGOING PROPERTY EXCEPT THOSE SPECIFICALLY DISCLOSED ABOVE. COMMUNITY ECONOMIC DEVELOPMENT FUND (CEDF) IS AUTHORIZED TO VERIFY THE INFORMATION DISCLOSED AND TO PERFORM A CREDIT INVESTIGATION AND BANK TRANSACTION ANALYSIS. CEDF RESERVES THE RIGHT TO ORDER CREDIT REPORTS AND/OR UPDATES OF BANK TRANSACTION ANALYSES AT ANY TIME BETWEEN THE DATE BELOW AND IF CREDIT IS GRANTED, UNTIL THE LOAN IS FULLY PAID OFF. THE UNDERSIGNED AUTHORIZES CEDF, IF CREDIT GRANTED, TO GIVE CREDIT INFORMATION TO ANY CREDIT REPORTING SERVICE AND TO ADVISE OTHERS ABOUT ITS CREDIT EXPERIENCE WITH YOUR ORGANIZATION. IT IS ALSO AGREED THAT THE FINANCIAL STATEMENT SHALL REMAIN THE PROPERTY OF CEDF WHETHER OR NOT CREDIT IS GRANTED. NOTICE: This program may be partially funded by the U.S. Small Business Administration (SBA). SBA’s funding is not an endorsement of any products, opinions or services. All SBA funded programs are extended to the public on a non-discriminatory basis. You are advised that the Community Economic Development Fund (the “CEDF”) may constitute a “public agency for purposes of the Connecticut Freedom of Information Act (the “Act”). All commercial or financial information provided to CEDF in connection with a loan application or an outstanding loan shall be considered “given in conference” as provided in the Act. CEDF will use reasonable efforts to protect any such information given in confidence from public disclosure. If you need help with any part of the loan process, please feel free to contact CEDF at (203) 235-2333 or toll-free (888) 835-2333. The information contained in this application is true to the best of my knowledge,and is being given for consideration of credit by CEDF.
By its (title)
(Signature)

Clear
Date

MonthDayYear
Date
By its (title)
(Signature)

Clear
Date

MonthDayYear
Date
Please verify that you are human*
Should be Empty:

NONPROFIT LOAN APPLICATION

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Project Sources and Use of Funds

Agreement to Apply