Business Loan Application

Applicant name*

First NameLast Name

Email*

example@example.com

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Please enter a valid phone number.

Personal annual income?*

Business annual income, if applicable?**

Business Type/industry*

Startup Or Existing Business?*

Do you have a business entity? If so what type?*

Business Entity Inception Date?*

Total current business debt, if applicable?*

Funding amount requested?*

FICO credit scores (All 3 bureaus)*

If W-2, have you been employed for at least one year?*

What is the percentage of your overall monthly debt? (Explanation): Percentage of monthly income covering personal monthly debt.*

Total number of personal credit lines in your name only?*

Total credit card limit combined?*

Overall credit card percentage of usage?*

Are there any individual credit cards above 30% usage?*

Number of inquiries on each bureau in the last 6 months?*

Any new loans /credit apply for or opened the last 6 months? If so explain:*

Any charge-offs / late payments or delinquencies in the past 3-5 years? If so explain:**

Do you have an active checking account?**

Any additional credit lines? (House, Car, etc)**

Did you complete last year's tax returns? If not have you filed an extension?*

Last year's gross business profit income?*

Additional notes: