Loan Application Form - Community Futures Pacific Northwest

What is your business structure?*

Sole ProprietorshipPartnershipCorporationOther

Full Name*

First NameMiddle Name(s)Last Name

Date of Birth*

Date

Phone Number*

Please enter a valid phone number.

Email Address*

example@example.com

Mailing Address*

Street Address

Street Address Line 2

CityProvince

Postal Code

Current Occupation*

Partner Information*

Director Information*

Do you have a co-signor?*

YesNo

Full Name*

First NameMiddle NameLast Name

Date of Birth*

Date

Phone Number*

Please enter a valid phone number.

Email Address*

example@example.com

Mailing Address*

Street Address

Street Address Line 2

CityProvince

Postal Code

Current Occupation*

Do you have a guarantor?*

YesNo

Full Name*

First NameMiddle NameLast Name

Date of Birth*

Date

Phone Number*

Please enter a valid phone number.

Email Address*

example@example.com

Mailing Address*

Street Address

Street Address Line 2

CityProvince

Postal Code

Current Occupation*

Which option best describes your business?*

New BusinessExisting Business

What will be the name of your business?*

What is the name of your business?*

What will be the business's product or service?*

What is your business's product or service?*

What will be the business address?*

Street Address

Street Address Line 2

CityProvince

Postal Code

What is the business address?*

Street Address

Street Address Line 2

CityProvince

Postal Code

What will be the business phone number?

Please enter a valid phone number.

What is the business phone number?*

Please enter a valid phone number.

What will be the business email address?

example@example.com

What is the business email address?*

example@example.com

How many full-time staff members do you anticipate having in the first year of business?*

Please include yourself in your answer.

How many part-time staff members do you anticipate having in the first year of business?*

How many full-time staff members do you currently have?*

Please include yourself in your answer

How many part-time staff members do you currently have?*

What are your income sources?*

Do you own any property that you plan to use to secure the loan?*

YesNo

Property Information*

Does the corporation own any property, that you plan to use to secure the loan?*

YesNo

Property Information*

Do you own a vehicle/ATV/etc. that you plan to use to secure the loan?*

YesNo

Vehicle/ATV/etc. Information*

Does the corporation own any vehicle/ATV/etc. that you plan to use to secure the loan?*

YesNo

Vehicle/ATV/etc. Information*

Do you own any other assets that you plan to use to secure the loan?*

YesNo

Additional Asset Information*

Does the corporation own any other assets that you plan to use to secure the loan?*

YesNo

Additional Asset Information*

Do you have any debt other than what is listed above?*

YesNo

Debt Details*

Does the corporation have any debt other than what is listed above?*

YesNo

Debt Details*

What is the loan amount you are requesting?*

Itemized Loan Allocation List*

Will you be personally investing money into the business?*

YesNo

How much will you be investing?*

Will the corporation be investing funds into the business?*

YesNo

How much will the corporation be investing?*

Please upload the last three years of tax assessment statements for the applicant and co-signor.

Please upload your last three years of tax assessment statements.

Please upload the last three years of tax assessment statements for each partner.

Please upload your Incorporation Documents

Please upload your Business Plan (Optional)

Please upload the most recent mortgage statements for each property.

Please upload your business financials for the last three years.

Please upload your driver's license.*

Please upload the driver's license's for the applicant and co-signor.*

Please upload the driver's license's for each partner.*

Please upload the driver's license's for each director.*

Please provide references (try to avoid family references). Having a minimum of 3 is strong and therefore recommended.*

Terms & Conditions

Certification of Information:
The applicant hereby certifies that all information provided is true, accurate, and complete. It is acknowledged that CFDC-PNW (Community Futures Development Corporation of the Pacific Northwest) will rely on this information not only for the current application but also for any future financing applications. The applicant understands that the provision of untrue, inaccurate, or incomplete information may, at the sole discretion of CFDC-PNW, result in the rejection of the loan application. If a loan has already been granted, CFDC may cease the disbursement of funds and demand the full repayment of the disbursed loan proceeds.

Consents to Inquiry:
The applicant, and if applicable, co-signor(s) or guarantor(s), consent to CFDC-PNW conducting inquiries and credit checks. This includes obtaining personal, business, and corporate information. In the case of incorporation, the corporation declares its authority to provide consent on behalf of its directors and officers. Refusal to consent, while not legally mandatory, may impede CFDC-PNW from considering the financing application. Pursuant to the Privacy Act, with certain exceptions, the applicant and, if applicable, co-borrower(s) or guarantor(s), and their incorporated directors and officers, have the right to access and protection of personal information obtained by CFDC-PNW.

Privacy Protection:
Application documents, agency reports, and other information acquired by CFDC-PNW in connection with this application are considered the property of CFDC-PNW.

Consent to Share:
The undersigned parties hereby grant consent to CFDC-PNW for the exchange of information with financial partners as required.

I, First Name* Last Name* , have thoroughly read and comprehended the terms and conditions outlined on this day, Date*.

By affixing my signature below, I confirm not only my understanding but also assert that I have obtained the necessary permission and authority to sign on behalf of co-signors, guarantors, and any other relevant parties associated with this application.*

Application Signed On:*

Welcome to the Community Futures Online Loan Application

Applicant Information

Partner Information

Director Information

Co-Signor Information

Guarantor Personal Information

Business Information

Personal Finances

Loan Allocation

References