MacAmerica Express Application

MacAmerica Express Application
Individual Applicants

Minimum loan amount of $150,000
Rep Name
Does this Applicant Hold Title to the Collateral?
Borrower Type
Name

First NameMiddle InitialLast Name
Address

Street Address

Street Address Line 2

CityState

Zip Code
County
Email
example@example.com
Phone Number
Format: (000) 000-0000.
Soc. Sec. #
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit year
Years at Current Address
Marital Status
Are you a U.S. citizen or permanent U.S. resident alien?
Are there additional individual applicants?
If yes, how many?
Is there a business applicant?

Additional Applicant #2
Does this Applicant Hold Title to the Collateral?
Borrower Type
Name

First NameMiddle InitialLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
County
Email
example@example.com
Phone Number
Format: (000) 000-0000.
Soc. Sec. #
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit year
Years at Current Address
Marital Status
Are you a U.S. citizen or permanent U.S. resident alien?

Additional Applicant #3
Does this Applicant Hold Title to the Collateral?
Borrower Type
Name

First NameMiddle InitialLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
County
Email
example@example.com
Phone Number
Format: (000) 000-0000.
Soc. Sec. #
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit year
Years at Current Address
Marital Status
Are you a U.S. citizen or permanent U.S. resident alien?

Additional Applicant #4
Does this Applicant Hold Title to the Collateral?
Borrower Type
Name

First NameMiddle InitialLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
County
Email
example@example.com
Phone Number
Format: (000) 000-0000.
Soc. Sec. #
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit year
Years at Current Address
Marital Status
Are you a U.S. citizen or permanent U.S. resident alien?

Additional Applicant #5
Does this Applicant Hold Title to the Collateral?
Borrower Type
Name

First NameMiddle InitialLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
County
Email
example@example.com
Phone Number
Format: (000) 000-0000.
Soc. Sec. #
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit year
Years at Current Address
Marital Status
Are you a U.S. citizen or permanent U.S. resident alien?

Business Applicant or Trust
Organization
Borrower Type
Business Name
Description of Business
Federal Tax ID#
Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
County
Name of principal signing on behalf of this entity

First NameLast Name
Title of principal
Are the individual borrowers related to this company?
Individual to the business
Is there another Business Applicant?

Business Applicant or Trust #2
Organization
Borrower Type
Business Name
Description of Business
Federal Tax ID#
Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
County
Name of principal signing on behalf of this entity

First NameLast Name
Title of principal
Are the individual borrowers related to this company?
Individual to the business
Is there another Business Applicant?

Business Applicant or Trust #3
Organization
Borrower Type
Business Name
Description of Business
Federal Tax ID#
Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
County
Name of principal signing on behalf of this entity

First NameLast Name
Title of principal
Are the individual borrowers related to this company?
Individual to the business
Is there another Business Applicant?

Business Applicant or Trust #4
Organization
Borrower Type
Business Name
Description of Business
Federal Tax ID#
Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
County
Name of principal signing on behalf of this entity

First NameLast Name
Title of principal
Are the individual borrowers related to this company?
Individual to the business
Is there another Business Applicant?

Business Applicant or Trust #5
Organization
Borrower Type
Business Name
Description of Business
Federal Tax ID#
Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
County
Name of principal signing on behalf of this entity

First NameLast Name
Title of principal
Are the individual borrowers related to this company?
Individual to the business
Is there another Business Applicant?

Loan Information

For ALL Applicants
At least one applicant must be a United States (U.S.) citizen or lawfully admitted alien to the U.S. who maintains permanent residence in the U.S. or a corporate entity or partnership whose members, stockholders, or partners holding a majority interest in the coroporate entity or partnership are citizens or lawfully admitted aliens. The following list of questions applies to ALL applicants.
Are you currently in bankruptcy or have you had a bankruptcy discharged within the past 48 months?
If Yes Explain:
Do you have any judgments against you?
If Yes Explain:
Are you a party to any lawsuits?
If Yes Explain:
Have you had property foreclosure or deed in lieu of foreclosure within the past 48 months?
If Yes Explain:
Are you in violation of any local, state, or federal zoning, operating, air quality, water, or environmental permits, laws, or requirements?
If Yes Explain:
Are any of the assets pledged as security for debts of others?
If Yes Explain:
Do you have any contingent liabilities?
If Yes Explain:
Have you endorsed or guaranteed notes for others?
If Yes Explain:
Are you obligated to pay alimony or child support?
If Yes Explain:
Confirmation

Loan Information

Continued
Requested Loan Amount (minimum loan amount of $150,000)
Loan Purpose
Who is the lender?
Total Loan Purpose Amount
"Total Loan Purpose Amount" must equal "Requested Loan Amount." Attach additional exhibits & descriptions as needed.
If this is a purchase, please provide additional detail in the purchase section below. If the loan request includes more than one purchase, please provide one total (consolidated) purchase price amount in the field below and breakdown each purchase in the sourses area provided.
Purchase Price
Is this an arm's length transaction
An arm's length transaction is when the buyers and sellers act in their own self-interest to negotiate the best deal. The parties involved have no pre-existing relationship to each other.
Sources for Purchase
Total Source for Purchase

Collateral-Property Information
Section/Township/Range or Street Address

Street Address if known

CityState

Zip Code
County
Commodities Grown on Property/Security
Check top two if Applicable
Commodities Grown on Property/Security
Property Information
Is there more than one property Securing the loan?
Additional Property Information / Short Legal

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Additional Property Information
Land Information
Residence - Number of Acres
Residence - Total Acre Value
Bare Land - Number of Acres
Bare Land - Total Acre Value
Buildings/Improvements - Number of Acres
Buildings/Improvements - Total Acre Value
*If the value of buildings/improvements cannot be broken down per acre, enter "1" for the number of acres and the total value of the buildings/improvements in the Value per Acre field. Plase also note, the final loan-to-value used for qualifying purpose will only take into considration the bare land value.
Other - Number of Acres
Other - Total Acre Value
Total Number of Acres
Total Acre Value
Collateral-Improvements, Lease and Rental Agreement
Is your property irrigated?
If yes, the Ariculture Water Supply Questionnaire (Form 1020) is required. The questionnaire should be completed by the applicant(s) and provided to the appraiser prior to the start of the appraisal. Upon approval Mac America will forward these documents to the applicant(s) for signatures.
Are there any improvements on the collateral?
Please provide a description of any improvements:
Are there any permanent plantings on the collateral?
Please provide a description of any permanent plantings:
Have any improvements, repairs, or work taken place on the property with in the last six months (including any that are currently underway or that will commence shortly?)
If yes, please explain
Is there a residence on the collateral?
If yes, is this your primary residence?

General Information
Are there any leases or rental agreements on the property?
If yes, are there any leases or rental agreements for which the remaining term(including any unexercised renewal options or rights) is three years or more?
Are there any manure easements, wind leases, cell towers, or other easements or agreements?
If yes, explain:
Provide a brief description (size and scope) of your current business operation. If no business operation exists, provide a brief background of the applicant(s).
Financial Information

Please provide consolidated balance sheet and income statement information for ALL applicants (including businesses and individuals)
Financial Statement as of: (within 90 days of application date preferred)

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Assets
Cash, Savings, Securities, ETC
Accounts Receivable
Crop Inventory
Market Livestock Inventory
Breeding Livestock Inventory
Machinery
Real Estate Market Value
Other Assets
Other Assets Description
Total Assets
Liabilities
Operating Debt
Credit Card Debt
Accounts Payable / Trade Debt
Equipment Debt / Vehicle Debt
Long-Term Debt
Other Liabilities
Description of Other Liabilities
Total Liabilities
Net Worth

Tax Return / Bank Information
Tax Return Year
Gross Farm Income (Schedule F: Line 9)
Net Farm Income (plus interest & depreciation)
(Schedule F Line 34 + Schedule F Line 14 + Schedule F Lines 21a and 21b)
Net Non-Farm Income
(Total Adjusted Gross Income Less Schedule F Line 34 + all non-Schedule F interest and depreciation)
Total Net Income (Net Farm + Net- Non-farm)
Do you have a current operating loan?
Current Operating Lender
Years with lender
Committed Operating Loan Amount
Upload Recent Tax Returns (Optional for loans of $1.5 million and under)

Two Most Recent Years’ Tax Returns required for loans over $1.5 million
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MacAmerica Express Application

Individual Applicants

Additional Applicant #2

Additional Applicant #3

Additional Applicant #4

Additional Applicant #5

Business Applicant or Trust

Business Applicant or Trust #2

Business Applicant or Trust #3

Business Applicant or Trust #4

Business Applicant or Trust #5

Loan Information

Loan Information

Collateral-Property Information

Land Information

Collateral-Improvements, Lease and Rental Agreement

General Information

Financial Information

Assets

Liabilities

Tax Return / Bank Information