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Company
First Name
Last Name
Title
Street
City
State
Zip
Phone
Fax
Type of Business
--None--
Agriculture
Apparel
Banking
Biotechnology
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Communications
Construction
Consulting
Education
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Energy
Engineering
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Environmental
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Not For Profit
Other
Recreation
Retail
Shipping
Technology
Telecommunications
Transportation
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Business Structure
--None--
Sole Proprietorship
Partnership
C Corporation
S Corporation
LLC
No. of Employees
Most Recent Year Sales
Current Expected Sales
--None--
<$50K
$50K to $100K
>$100K
Date Business Started
Referred By
Referred By Org
Current Bank
Banking Officer
Loan Information Summary
Loan Request
Purpose of Loan
Purchase business equipment
Purchase company vehicle
Finance outstanding accounts receivable
Purchase a building
Hire new employees or contractors
Finance new product development
Purchase another business or franchise
Improve building facilities
Buy out a business partner
Pay off personal CCs (biz exps)
Refinance or restructure existing debt
Buy more inventory
Purchase computer for telephone sys
Build a website or online store
Pay for day-to-day expenses efficiently
Cover seasonal production costs
Fill a large customer order
Pay vendors earlier to take discounts
Pay sales travel costs
Pay online product, supply orders
Launch a new product line
Open another location
Relocate the business
Other credit needs
Type of Loan
Term Loan
Working Capital
Revolving Line of Credit
Fixed Asset/Equipment financing
Vehicle financing
Real Property Financing
Business Credit Cards
Start up
Business Acquisition
Collateral
--None--
Residence
Commercial Building
Business Inventory
Accounts Receivable
Contracts
Other Business Assets
Comments
We appreciate your business. We will treat you as if you are a part of our family.