• LEY COMMERCIAL LOAN APPLICATION

  • I. PERSONAL OR BORROWING ENTITY INFORMATION

  • Complete this section for all guarantors and spouse or non-spouse, if applicable. (attach additional sheets if needed.) Assitional guarantors must complete sections I, V-XI
  • Borrower is an:
  • Borrowing entity is a:
  • Date Formed:
     - -
    2 digit month, 2 digit day, 4 digit year
  • Any individual who owns 25% or more of the borrowing entity is required to be a guarantor of the loan. Please list ALL additional owners below or attach organization chart.
  • Rows
  • Date of Birth:
     - -
    2 digit month, 2 digit day, 4 digit year
  • Date of Birth:
     - -
    2 digit month, 2 digit day, 4 digit year
  • Marital Status:
  • Marital Status:
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • II. LOAN REQUEST

  • Commercial Mortgage Type Applied For:
  • Loan Purpose:
  • Amortization:
  • Loan Program
  • Prepayment Type:
  • Original Purchase Date:
     - -
    2 digit month, 2 digit day, 4 digit year
  • (*Please do not include mortgage payment or depreciatior as a part of the Actual Expenses above.)
  • Is the property subject to any additional liens, encumbrances or restrictions?
  • 120 S Olive Ave., Suite 308 West Palm Beach, FL 33401

  • III. SUBJECT PROPERTY INFORMATION

  • Commercial Property Type:
  • 1-4 Investment Property Type:
  • Does the property have?
  • Hazardous material handling/Licensing
  • Source of Value Estimate:
  • Owner Occupied:

  • IV. BUSINESS INFORMATION

  • Please complete if you are Self-Employed or the Borrower is a Business Entity.
  • Will this business occupy the subject property?
  • Type of Business:

  • V. EMPLOYMENT INFORMATION

  • Self Employed:
  • Self Employed:

  • VI. ANNUAL INCOME AND COMBINED HOUSING EXPENSE INFORMATION

  • VII. ASSETS AND LIABILITIES

  • VIII. PERSONAL DECLARATIONS

  • If you answer "Yes" to any questions A through F, please provide a separate explanation.
  • VIII. PERSONAL DECLARATIONS
    Rows

  • IX. BUSINESS DECLARATIONS

  • Please select N/A if you are closing as an individual and your business is not going to occupy the subject property.
  • Neither my business, nor any principal of my business has declared bankruptcy in the last 4 years.
  • Neither my business, nor any principle of my business is a party to any lawsuit.
  • My business has never defaulted on any Federal debt including SBA loans.
  • No principle of my business has had a property foreclosed within the past 4 years.
  • The business has neither been denied a license, certification or ability to conduct business nor been suspended or administratively limited to its ability to conduct business.

  • X. GENERAL AUTHORIZATION

  • I HEREBY AUTHORIZE LENDER TO VERIFY ANY AND ALL INFORMATION PROVIDED OR REQUESTED WITH THIS APPLICATION, INCLUDING BUT NOT LIMITED TO MY PAST AND PRESENT EMPLOYMENT, EARNING RECORDS, BANK ACCOUNTS, STOCK HOLDINGS AND ANY OTHER ASSET BALANCES NEEDED TO PROCESS MY LOAN APPLICATION.
  • I UNDERSTAND THAT FALSE INFORMATION AND STATEMENTS MAY RESULT IN POSSIBLE PROSECUTION UNDER FEDERAL AND STATE LAWS. FURTHER, I UNDERSTAND THAT MY INFORMATION WILL BE SCRUBBED AGAINST THE OFAC, SDN LISTS, EXCLUSIONARY AND OTHER LISTS TO CONFIRM COMPLIANCE WITH THE US PATRIOT ACT, COUNTER-TERRORISM REGULATIONS AND BSA/AML REGULATIONS.
  • I CERTIFY BY SIGNING BELOW THAT THIS IS NOT AN APPROVAL OR COMMITMENT TO LEND AND THAT I MAY BY DENIED AT ANY TIME DURING THE PROCESS FOR REASONS INCLUDING BUT NOT LIMITED TO CREDIT WORTHINESS SUCH AS: COLLATERAL ISSUES, BUSINESS PRACTICES OR UNSTABLE GOVERNMENT/POLITICAL CLIMATE WITHIN A COUNTRY.

  • Applicant

  • I AUTHORIZE LENDER TO MAKE ALL INQUIRES NECESSARY THAT VERIFY THE ACCURACY OF THE STATEMENTS MADE HEREIN AND TO DETERMINE MY CREDITWORTHINESS.
  • Date:
     - -
    2 digit month, 2 digit day, 4 digit year

  • Co-Applicant

  • I AUTHORIZE LENDER TO MAKE ALL INQUIRES NECESSARY THAT VERIFY THE ACCURACY OF THE STATEMENTS MADE HEREIN AND TO DETERMINE MY CREDITWORTHINESS.
  • Date:
     - -
    2 digit month, 2 digit day, 4 digit year

  • X. INFORMATION FOR GOVERNMENT MONITORING PURPOSES

  • The purpose of collecting this information is to help ensure that all applicants are treated fairly and that the housing needs of communities and neighborhoods are being fulfilled. For residential mortgage lending, federal law requires that we ask applicants for their demographic information (ethnicity, sex, and race) in order to monitor our compliance with equal credit opportunity, fair housing, and home mortgage disclosure laws. You are not required to provide this information, but are encouraged to do so. The law provides that we may not discriminate on the basis of this information, on whether you choose to provide it. However, if you choose not to provide the information and you have made this application in person, federal regulations require us to note your ethnicity, sex, and race on the basis of visual observation or surname. The law also provides that we may not discriminate on the basis or age or marital status information you provide on this application.
    Instructions: You may select one or more "Hispanic or Latino" origins and one or more designations for "Race." If you do not wish to provide some or all of this information, select the applicable check box.

  • BORROWER

  • ETHNICITY

  • RACE

  • CO-BORROWER

  • ETHNICITY

  • RACE

  • Hispanic or Latino
  • American Indian or Alaska Native-
  • Hispanic or Latino
  • American Indian or Alaska Native-
  • Not Hispanic or Latino
  • Not Hispanic or Latino

  • SEX:

  • SEX:

  • Male
  • Male
  • White
  • White

  • To Be Completed by financial Institution (for application taken in person):

  • Was the ethnicity of the Borrower collected on the basis of visual observation or surname?
  • Was the sex of the Borrower collected on the basis of visual observation or surname?
  • Was the race of the Borrower collected on the basis of visual observation or surname?

  • The Demegraphic Information was provided through:

  • Face-to-Face Interview (includes Electronic Media w/Video Component)
  • Fax or Mail

  • Closing Notes: (1) IRS Form 4506T to be signed prior to underwriting for all borrowers and businesses related to the transaction. (2) Signatures on all tax returns may be completed at closing. This application is for a business purpose loan secured by commercial real estate. The undersigned specifically acknowledge and agree that (1) the loan requested by this application will be secured by a first mortgage or deed of trust on the property described herein; (2) the property will not be used for any illegal or prohibited purposes or use; (3) all statements made in this application are made for the purpose of obtaining the loan indicated herein; (4) occupation of the property will be as indicated above; (5) verification or reverification of any information contained in the application may be made at any time by the Lender, its agents, successors and assigns, either directly or through a credit reporting agency, from any source named in this application, and the original copy of this application will be retained by Lender, even if the loan is not approved; (6) the Lender, its agents, successors and assigns will rely on the information contained in the application and I/we have continuing obligation to amend and/or supplement the information provided in this application if any of the material facts which I/we have represented herein should change prior to closing; (7) In the event my/our payments on the loan indicated in this application become delinquent, the Lender, its agents, successors and assigns, may, in addition to all their other rights and remedies, report my/our name(s) and account information to a credit reporting agency; (8) ownership of the loan may be transferred to successors or assigns of the Lender without notice to me and/or the administration of the loan account may be transferred to an agent, successor or assign of the Lender with prior notice to me; (9) the Lender, its agents, successors and assigns make no representations of warranties, express or implied, to the Borrower(s) regarding the property, the condition of the property, or the value of the property; and (10) I/we understand and hereby agree that all principals of the company have been identified to the Lender and will sign the note personally guaranteeing repayment of the obligation. I/we the undersigned certify that the information provided in this loan application and in all loan documents submitted to Lender is true and correct as of the date set forth opposite my/our signature(s) on this application and acknowledge my/our understanding that any intentional or negligent misrepresentation of the information contained in this application may result in civil liability and/or criminal penalties including, but not limited to, fine or imprisonment or both under the provisions of Title 18, United States Code, Section 1001, et seq. and liability for monetary damages to the Lender, its agents, successors and assigns, insurers and any other person who may suffer any loss due to reliance upon any misrepresentation which I/we have made on this application.

  • If your application for business credit is denied, you have the right to a written statement of the specific reasons for the denial. To obtain the statement, please contact your lender within 60 days from the date you are notified of our decision. We will send you a written statement of reasons for the denial within 30 days of receiving your request for the statement.

  • Notice: The federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national origin, sex, sexual orientation, marital status, age (provided the applicant has the capacity to enter into a binding contract); because all or part of the applicant's income derives from any public assistance program; or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act. The federal agency that administers compliance with this law concerning this creditor is Federal Trade Commission, Equal Credit Opportunity, Washington, D.C., 20580.

  • I. PERSONAL OR BORROWING ENTITY INFORMATION - continued.

  • Date of Birth:
     - -
    2 digit month, 2 digit day, 4 digit year
  • Date of Birth:
     - -
    2 digit month, 2 digit day, 4 digit year
  • Marital Status:
  • Marital Status:
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • V. EMPLOYMENT INFORMATION - continued.

  • Self Employed:
  • Self Employed:

  • VI. ANNUAL INCOME AND COMBINED HOUSING EXPENSE INFORMATION - continued.

  • VII. ASSETS AND LIABILITIES - continued.

  • VII. ASSETS AND LIABILITIES - continued.
    Rows

  • VIII. PERSONAL DECLARATIONS - continued.

  • If you answer "Yes" to any questions A through F, please provide a separate explanation.
  • A. Are there any outstanding judgments against you?
  • B. Have you declared bankruptcy within the last 4 years?
  • C. Have you had property foreclosed upon or given title in lieu thereof in the last 4 years?
  • D. Are you party to a lawsuit?
  • E. Have you directly or indirectly been obligated on any loan which resulted in foreclosure, transfer of title in lieu of foreclosure or judgment in the last 4 years?
  • F. Are you presently delinquent or in default on any Federal debt or any other loan, mortgage, financial obligation or loan guarantee?
  • G. Are you obligated to pay alimony, child support or separate maintenance?
  • H. If applicable, do you intend to occupy the property as your primary housing residence?
  • I. Have you been convicted of a felony within the past 10 years?
  • J. Are you a U.S. citizen?
  • K. Are you a permanent resident alien?

  • X. GENERAL AUTHORIZATION - continued.

  • I HEREBY AUTHORIZE LENDER TO VERIFY ANY AND ALL INFORMATION PROVIDED OR REQUESTED WITH THIS APPLICATION, INCLUDING BUT NOT LIMITED TO MY PAST AND PRESENT EMPLOYMENT, EARNING RECORDS, BANK ACCOUNTS, STOCK HOLDINGS AND ANY OTHER ASSET BALANCES NEEDED TO PROCESS MY LOAN APPLICATION.

    I UNDERSTAND THAT FALSE INFORMATION AND STATEMENTS MAY RESULT IN POSSIBLE PROSECUTION UNDER FEDERAL AND STATE LAWS. FURTHER, I UNDERSTAND THAT MY INFORMATION WILL BE SCRUBBED AGAINST THE OFAC, SDN LISTS, EXCLUSIONARY AND OTHER LISTS TO CONFIRM COMPLIANCE WITH THE US PATRIOT ACT, COUNTER-TERRORISM REGULATIONS AND BSA/AML REGULATIONS.

    I CERTIFY BY SIGNING BELOW THAT THIS IS NOT AN APPROVAL OR COMMITMENT TO LEND AND THAT I MAY BY DENIED AT ANY TIME DURING THE PROCESS FOR REASONS INCLUDING BUT NOT LIMITED TO CREDIT WORTHINESS SUCH AS; COLLATERAL ISSUES, BUSINESS PRACTICES OR UNSTABLE GOVERNMENT/POLITICAL CLIMATE WITHIN A COUNTRY.

  • Applicant

  • I AUTHORIZE LENDER TO MAKE ALL INQUIRES NECESSARY THAT VERIFY THE ACCURACY OF THE STATEMENTS MADE HEREIN AND TO DETERMINE MY CREDITWORTHINESS.
  • Date:
     - -
    2 digit month, 2 digit day, 4 digit year

  • Co-Applicant

  • I AUTHORIZE LENDER TO MAKE ALL INQUIRES NECESSARY THAT VERIFY THE ACCURACY OF THE STATEMENTS MADE HEREIN AND TO DETERMINE MY CREDITWORTHINESS.
  • Should be Empty: