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Business Loan Instructions

This questionnaire is intended for current customers or those moving to our geographic area who will be banking with us. If you will be relocating to our area, please advise us of your anticipated date of arrival.

If this does not apply to you, please be advised that we are not currently lending to non-customers out of our geographic area.

If you apply, we may automatically access your credit record. Some lenders deny credit due to excessive inquiries and submitting this in error may reflect poorly if you apply elsewhere in the near future.

Warning, misrepresentation of your assets in a credit transaction could result in a violation of Federal Law. (Sec. 18 U.S.C. 1014)

Due to the Children's Online Privacy Protection Act, we do not intend to collect information about children who are under the age of 13. By completing and submitting this form, you certify that you are over the age of 13.

Joint Application
Applicant's Personal Information
Enter your social security number.
Contact Information
Enter a phone number where you can easily be contacted.
Address
Business Information
Business Contact Number
Enter a phone number where you can easily be contacted.
Business Address
Type of Business
Enter the year the business was established or incorporated.
Enter the number of employees you have employed.
Financial Institution
$
$
$
Business
As reported on the latest Federal Income Tax Return (FIT).
$
Enter the Gross Annual Income amount.
$
Enter the taxable income.
$
Enter the amount of Federal taxes paid.
$
Enter the amount of cash and marketable assets.
$
Enter the amount value assets.
$
Enter the amount due over the next 12 months.
$
Enter the amount due after the next 12 months.
Principle
$
Enter the Gross Annual Income amount.
$
Enter the taxable income.
$
Enter the amount of Federal taxes paid.
$
Enter the amount of cash and marketable assets.
$
Enter the amount value assets.
$
Enter the amount due over the next 12 months.
$
Enter the amount due after the next 12 months.
Existing Financial Obligation (Business)
$
Enter the amount of existing long term obligations, such as to supplies, equipment vendors, leases, etc.
$
Enter the amount for contingent liabilities.
Principle
$
Enter the amount of existing long term obligations, such as to supplies, equipment vendors, leases, etc.
$
Enter the amount for contingent liabilities.
Loan Information
Enter the amounts for each of the planned uses for the loan.
$
Enter the amount to be used to acquire new land.
$
Enter the amount to be used for new construction, expansion, and repairs.
$
Enter the amount to be used to acquire and/or repair machinery.
$
$
Enter the amount to go towards working capital to include accounts payable.
$
Enter the amount being used to acquisition other businesses.
$
Enter the amount which will be going towards SBA loans.
$
Enter the amount which will be going towards non SBA loans.
$
Enter the amount which will go towards other Debts.
$
Enter the amount which will go towards other uses.
Describe how the amount will be used for other expenses.
$
Enter the total amount from all the boxes above.
Enter the requested maturity date. e.g. 06/17/2021
$
Enter the monthly payment you would prefer.
$
Describe the collateral offered for this request.
Questionnaire
Preparer Information
Enter your first and last names. Middle name or initial is optional.
Enter your position with the business.
Enter any additional comments in the box above.
By clicking Submit below, you agree that this is not a loan application. Further, you acknowledge the bank has the authority to obtain a credit report on the business principal (individual) and or business. A formal application will require additional information including, but not limited to, a detailed current financial statement and balance sheet acceptable to the bank and signed by the borrower and two years previous Federal income tax returns, both personal and business.