Client Intake Form

Client Intake Form

Personal Information
Loan Officer Preference
Name of Borrowing Entity*

PrefixFirst NameMiddle NameLast Name
E-mail of Borrowing Entity*
Phone number of Borrowing Entity

Area CodePhone Number
Mobile Phone number of Borrowing Entity

Area CodePhone Number
Fax Number of Borrowing Entity

Area CodePhone Number
Address of Borrowing Entity*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Date of Birth of Borrowing Entity*

MonthDayYear

Client Intake Form

Project Details
Applying as*

Sole ProprietorPartnershipS CorporationC CorporationLLCOther
Current Business Location

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
If Purchasing Owner-Occupied Real Estate, Planned Business Location

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Project Marketing Material

Upload a File

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Project Information

Upload a File

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Client Intake Form

Financial Information
Upload Most Current Balance Sheet and Income Statement

Upload a File

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Business Debt Schedule

Client Intake Form

Guarantor
Any Natural Person owning 15% or more of Borrowing Entity must provide the following items: 1) Current Personal Financial Statement 2) 3 years of most recent business tax returns 3) 3 years of most recent personal tax returns
Are there additional guarantor(s)? If yes, please list name(s):
If there are additional guarantors, please list email addresses:
If there are additional guarantors, please list phone numbers:
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Client Intake Form

Loan Details
Loan Reason

ConstructionAsset PurchaseRefinancingOther
Project Gross Value
Loan Amount

Client Intake Form

Submit my Intake Form
The information provided in this application is confidential and may only be seen by your loan officer and his assistant.
I agree that the information entered herein is true and correct.

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