LOC / Term Loan App
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Business Legal Name
*
Business DBA Name
Address
*
Street Address
Street Address Line 2
City
State
Zip
Business Phone
*
Format: (000) 000-0000.
Business Email
*
example@example.com
Legal Entity
*
Please Select
Sole Proprietor
LLC
C-Corporation
S-Corporation
General Partnership
Limited Liability Partnership
EIN
*
State of Incorporation?
*
Industry
*
Please Select
Accommodation and Food Services
Administrative and Support and Waste Management and Remediation Services
Agriculture, Forestry, Fishing and Hunting
Arts, Entertainment, and Recreation
Construction
Educational Services
Finance and Insurance
Health Care and Social Assistance
Information
Management of Companies and Enterprises
Manufacturing
Mining, Quarrying, and Oil and Gas Extraction Other Services (except Public Administration)
Professional, Scientific, and Technical Services
Public Administration
Real Estate and Rental and Leasing
Retail Trade
Transportation and Warehousing
Utilities
Wholesale Trade
Date Business Started
*
/
Month
/
Day
Year
Date
Do you have tax liens?
*
Please Select
No
>$50,000
>$100,000
Have you had a personal or business bankruptcy?
*
Please Select
No
Less than 3 years ago
More than 3 years ago but less than 7 years ago
More than 7 years ago
Number of Employees?
*
Does the business entity (or an affiliated real estate holding company) own the property where the business is located?
*
Please Select
YES
NO
Current Bank/s
*
How much funding are you looking for?
*
Why do you want the funds?
*
Please Select
Working Capital
Refinance Debt
Purchase or Lease Equipment
Purchase or Refinance Commercial Real Estate
Buy Out a Partner
Expand a Business
Open a Franchise
Other
#1 OWNER INFORMATION
Name
*
Address
*
Street Address
Street Address Line 2
City, State Zip
State / Province
Postal / Zip Code
Mobile
*
Format: (000) 000-0000.
Email
*
example@example.com
SSN#
*
% of Ownership
*
Date of Birth
*
/
Month
/
Day
Year
Date
Personal Experian Credit Score
*
Your Experian "FULL PDF" Report is required - NOT AN IMAGE snapshot - Free to download at https://www.experian.com/
*
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Rent or own home?
*
Please Select
Own
Rent
Date moved to this address (home)
*
/
Month
/
Day
Year
Date
Monthly Housing Expense (Principal, Interest, Taxes & Insurance or Rent):
*
Total Annual Income
*
Total Cash (Checking & Savings)
*
Total Net Worth?
*
US Citizen?
*
Please Select
Yes
No
Owner/Principal Signature
*
Print Name
*
Date
*
/
Month
/
Day
Year
Date
#2 OWNER INFORMATION (If owns > 10%)
Name
Address
Street Address
Street Address Line 2
City, State Zip
State / Province
Postal / Zip Code
Mobile
Format: (000) 000-0000.
Email
example@example.com
SSN#
% of Ownership
Date of Birth
/
Month
/
Day
Year
Date
Personal Experian Credit Score
Rent or own home?
Please Select
Own
Rent
Date moved to this address (home):
-
Month
-
Day
Year
Date
Monthly Housing Expense (Principal, Interest, Taxes & Insurance or Rent):
Total Annual Income
Total Cash (Checking & Savings)
Total Net Worth?
US Citizen?
Please Select
Yes
No
US Permanent Resident?
Please Select
Yes
No
Owner/Principal Signature
Print Name
Date
/
Month
/
Day
Year
Date
Upload Docs
Latest filed Business Tax Return
*
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Latest filed Personal Tax Return
*
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Debt Schedule - Please list any current LOC, Term Loans, SBA and MCA (not credit cards)
*
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Bank Statements
Upload previous 3 months bank statements
Latest Business Bank Statement
*
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Previous Business Bank Statement
*
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Previous Business Bank Statement
*
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