Commercial Loan Application

 
Credit Requested
Amount Requested
Term of Credit Requested
Loan Type
Market Survey
Purpose of Credit Request
Credit Request Applicant Only
Joint with Co-Applicant(s)
Completion Instructions for Applicant

Complete the Applicant information for the first Applicant. Mark the appropriate box to indicate whether the Applicant is applying as a Borrower, Guarantor, Cosigner, Grantor (of collateral), or Other for a different capacity. If the Applicant is a married individual, he or she may apply for individual credit. (Do not complete Marital Status question below if application is for individual unsecured credit.)

Applicant is a:   Borrower   Guarantor   Cosigner   Grantor  Other

Name of Applicant
(Business Name or Last Name if Individual)
Applicant First Name
(If Individual)
SSN/TIN #
Assumed Business Names (if any)
Telephone Number
Filing Dates
Filing Locations
DBA Name
Check Appropriate Box
  If you are applying for individual credit and are relying on your own income or assets and not the income or assets of another person as the basis for repayment of the credit requested, do not complete the section for marital status. 
  If you are applying for individual credit, but are relying on income from alimony, child support, or separate maintenance or on the income or assets of another person as the basis for repayment of the credit requested, complete all sections to the extent possible, providing information about the person whose alimony, support, or maintenance payments or income or assets you are relying.
  If you are applying for joint credit with another applicant, complete all sections and attach joint application.
Marital Status (If Individual Borrower)
Street Address
Mailing Address
Principal Office Address (if not listed above)
State of Organization

Applicant Is:  An Individual   An Association   A Proprietorship   A Trust   A Partnership

A Gov't Entity   A Corporation   A LLC   Non-Profit

Schedule of Collateral Offered by this Applicant
Description Value Total Liens Ownership Status for this Applicant Creditor Name
Purchase Money
Presently Owned
Purchase Money
Presently Owned
Purchase Money
Presently Owned
Purchase Money
Presently Owned
Purchase Money
Presently Owned
Purchase Money
Presently Owned

Schedule of Assets
Description Value Subject to Debt

Total  

   

Schedule of Liabilities
Description Value Subject to Debt

Total 

 

Schedule of Expenses
Description Type Amount Per

 Annualized Total

 

Income Schedule
Description Type Annualized Amt.

Annualized Total 

  

Financial and Income Statement Summary
Total Assets Total Annual Income
Total Liabilities Total Annual Expenses
Net Worth Net Annual Cash Flow

Relationship Information - Applicant's History with Lender          New/ Existing Customer
Customer Since (MM-YYYY)
Last Tax Return Date on File (YYYY)
Last Financial Stmt Date (MM-DD-YYYY)
Last Credit Report Date (MM-DD-YYYY)
Last Credit Bureau
Liabilities with Lender
Direct
Contingent
Total
Deposits with Lender
DDA Avg.
Other Avg.
Total Avg.
Total Credit with Lender
New Credit
Proposed Total

Authorized Signers for this Applicant         
Name Title
Address SSN
Name Title
Address SSN
Name Title
Address SSN
Name Title
Address SSN
Name Title
Address SSN

Applicant Signatures

I/We hereby apply for the loan or credit described in this application on behalf of the applicant business. I/We certify that I/we made no misrepresentation in this loan application or in any related documents, that all information is true and complete, and that I/we did not omit any important information. I/We agree that any property securing the loan or credit will not be used for any illegal or restricted purpose. Lender is authorized to verify with other parties and to make any investigation of my/our credit, either directly or through any agency employed by the Lender for that purpose. Lender may disclose to any other interested parties information as to Lender's experiences or transactions with my/our account. I/We understand that Lender will retain this application and any other credit information Lender receives, even if no loan or credit is granted. These representations and authorizations extend not only to lender, but also to any insurer of the loan and to any investor to whom lender may sell all or any part of the loan. I/We further authorize Lender to provide any such insurer or investor any information and documentation that they may request with respect to my/our application, credit, or loan.

 

By By
By By