Fillable 2018 09 Business Loan Application And Agreement Packet (Bangor Savings Bank)

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2018 09 Business Loan Application And Agreement Packet (Bangor Savings Bank)

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The 2018 09 Business Loan Application And Agreement Packet (Bangor Savings Bank) form is 8 pages long and contains:

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  • 58 check-boxes
  • 176 other fields

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BUSINESS
LOAN
APPLICATION
AND
AGREEMENT
BUSINESS INFORMATION (Please complete all areas of this section)
Legal Name of Business Applicant(s)
Business Phone
( )
Federal Tax ID#
When two or more individuals are applying for joint credit, read the statement and initial in the
boxes to the right: We intend to apply for joint credit.
Applicant
Co-Applicant(s)
Business Address (No P.O. Boxes)
State
Zip
Mailing Address (if different)
State
Zip
Type of
Organization:
☐ Sole Proprietorship ☐ Partnership ☐ Limited Liability Company ☐ S. Corp. ☐ C. Corp. ☐ Non-Profit
Description of Business:
Email:
Last Full Year-End (MM/YY)
Gross Annual Sales
$
Annual Net Income
$
Interest Expense
$
Depreciation Expense
$
Total Business Assets
$
Total Business Liabilities
$
Organized In Which State
Date Business Established
Date Business Purchased
Checking Account Balance
$
Bank Where Account is Held
Savings Account Balance
$
Bank Where Account is Held
No. of Employees
OUTSTANDING BUSINESS LOANS, INCLUDE THOSE WITH BANGOR SAVINGS BANK:
(Use Additional Sheets if Necessary)
Lender Type of Loan Current Balance Monthly Payment Loan Secured By
$ $
$ $
$ $
CREDIT REQUEST
☐ Complete Overdraft Protection ($2,500 - $10,000)
$
☐
Line of Credit (Minimum $10,000)
$
☐
Term Loan (Minimum $5,000)
$
Term:
☐
Commercial Real Estate Mortgage (Minimum $25,000)
$
Term:
☐
Other:
$
Term:
COLLATERAL
Check all that apply
Collateral Value
Value Based On
Name Title Is Held
Secure Other Loans?
☐ All Business Assets
$
Yes ☐
No ☐
☐ Accounts Receivable/Inventory
$
Yes ☐
No ☐
☐
Equipment/Furniture/Fixtures
$
Yes ☐
No ☐
☐ Real Estate
$
Yes ☐
No ☐
☐
Vehicle(s)
$
Yes ☐
No ☐
☐
Savings/CD’s/Securities
$
Yes ☐
No ☐
☐
Other:
$
Yes ☐
No ☐
Please describe the collateral securing the loan(s):
Is the collateral being pledged owned by the business or owners of the business? Yes ☐
No ☐
Existing customer with Bangor Savings Bank? Yes ☐
No ☐
2
DECLARATIONS
Are you or is your business a party to, or threatened with any claim or lawsuit? Yes ☐
No ☐
For loan requests of $50,000 or less,
please complete the Personal
Financial Information section below.
For loan requests over $50,000
please complete our separate
Personal Financial Statement form
and provide the following:
Have you or has any business that you owned or operated ever declared bankruptcy? Yes ☐
No ☐
Do you or does your business owe any taxes for years prior to the current year? Yes ☐
No ☐
Has the business incurred a loss in any of the last 3 years? Yes ☐
No ☐
Is the business under any agreement that would change the ownership of the business? Yes ☐
No ☐
Does this Business Applicant have any other credit applications pending? Yes ☐
No ☐
• Year-end Business Tax Returns (All Schedules) - Two (2) years if request is less than $250,000; three (3) years if $250,000 or greater
• Year-end Financials (Balance Sheet & Income Statement)
• Interim Business Balance Sheet and (YTD) and Income Statement - Within 90 days of application date
• Personal Tax Returns (All Schedules) - Two (2) year if request is less than $250,000; three (3) years if $250,000 or greater
PERSONAL FINANCIAL INFORMATION –
Company Owners 20% or More and Other Guarantors (Use Additional Sheets if Needed)
1
Name
Title
% of Business
Owned
Home Phone
( )
Social Security Number
Date of Birth
Physical Street Address (No P.O. Boxes)
City
State
Zip
U.S. Citizen
Driver’s License #
State:
Occupation:
Date Issued:
Expiration Date:
Employer
Years With
Employer
Will You Continue With This Employment?
Yes ☐ No ☐
Total Annual
Income*
$
Cash and
Investments
$
If Homeowner:
Market Value
$
Current Mortgage
Balance
$
Mortgage or Rent
Payment
$
Other Personal
Assets
$
Personal
Liabilities
$
*Note: Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.
2
Name
Title
% of Business
Owned
Home Phone
( )
Social Security Number
Date of Birth
Physical Street Address (No P.O. Boxes)
City
State
Zip
U.S. Citizen
Driver’s License #
State:
Occupation:
Date Issued:
Expiration Date:
Employer
Years With
Employer
Will You Continue With This Employment?
Yes ☐ No ☐
Total Annual
Income*
$
Cash and
Investments
$
If Homeowner:
Market Value
$
Current Mortgage
Balance
$
Mortgage or Rent
Payment
$
Other Personal
Assets
$
Personal
Liabilities
$
*Note: Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.
Purpose of Loan Request:
3
Agreement and
Signatures
By signing below, each principal, owner, guarantor, or co-borrower that will be personally liable for the debt (“You” or “I”) hereby authorizes Bangor
Savings Bank (the “Bank”) to make or have made on each and any of them any credit, employment or investigative inquiry that the Bank determines
appropriate for the extension of credit or the collection of amounts owed to the Bank. The Bank can furnish information concerning your account
to consumer reporting agencies and others who may properly re
ceive that infor
mation. Upon request, you will be informed whether or not a consumer
report was requested, and if a report was requested, you will be informed of the name and address of the consumer-reporting agency that furnished the
report. You further certify that the credit being applied for will be used for business purposes.
If you apply for and are approved for an overdraft protection line of credit, you may be approved up to the maximum amount which is available and
for which you qualify. If the line of credit is approved, you will receive from the Bank a welcome letter and a credit agreement which will set forth
the terms and conditions governing the credit line. Your credit limit, finance charges, monthly payment, and other terms pertaining to the credit
line will be set forth in the credit agreement. The
se te
rms give the Bank certain rights upon default, including a right of setoff against accounts you
may hold with the Bank, the right impose late fees and interest rate increases, the right to seek collection costs, and the right to terminate the credit line,
this Agreement, and the credit agreement. You should carefully review the terms of the credit agreement before making draws on the credit line.
By making a draw on the c
redit line, you will be representing and agreeing that you have reviewed and will be bound by the terms of
this application and agreement, the credit agreement, the welcome letter and any other supplemental agreement provided to you. You agree
that no further signatures will be necessary to bind you to the credit agreement and/or any supplemental agreement. If the line of credit
is approved as secured, you may be required to sign addition
al documents evidencing a security interest before the line of credit is made available to
you.
BY SIGNING THIS AGREEMENT, YOU HEREBY EXPRESSLY AND VOLUNTARILY WAIVE THE RIGHT TO ANY JURY TRIAL IN
ANY ACTION, PROCEEDING, OR COUNTERCLAIM INVOLVING THE BANK AS TO ANY MATTER, CLAIM OR CAUSE OF
ACTION ARISING OUT OF OR IN ANY WAY RELATED TO THIS AGREEMENT OR THE CREDIT AGREEMENT.
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT: To help the government fight the funding of
terrorism and money laundering activities, Federal law requires all financial institution to obtain, verify, and record information that identifies each
person who opens an account. What this means for you: When you open an account, we will ask for your name, address, date of birth, business
documents, and other information that will allow us to identify you. We may also ask to see your driver’s license or other
identifying d
ocuments.
Additional regulatory disclosure is attached as the final page of this document.
I represent and warrant that I am duly authorized to execute and enter into this application for the Applicant. Everything that I have stated and all
financial information provided as part of this application is correct to the best of my knowledge. By signing below, I agree to be bound by this
application and agreement, including, if requested and approved, all obligations hereunder, including the obligation to agree to review and be bound
by the terms of the credit agreement before making draws on a line
of credit.
COMPANY AND GUARANTOR SIGNATURES - (Please sign both places)
Company Authorized Signer
X
Title
Date
Guarantor #1
X
Company Authorized Signer
X
Title
Date
Guarantor #2
X
Guarantor #3
X
Guarantor #4
X
Guarantor #5
X
BANK USE ONLY
TO BE COMPLETED BY THE INTERVIEWER
This application was taken by (please check appropriate box below):
☐ Face-to-face interview ☐ By mail, electronic delivery, or dropped-off
If loan is to an individual and is HMDA reportable, GMI Data Reporting Form is required.
Interviewer’s Name:
Date Application Received:
Officer Number:
Branch Number:
BSB Form No. BLA V6 09.2018
REGULATORY NOTICE
Thank you for choosing Bangor Savings Bank for your commercial banking needs. Upon receipt of the
fully completed application form, your application is in process. We are required to provide the
Authorizations and Notifications below. Please feel free to contact your Lender with any questions.
The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the
basis of race, color, religion, national origin, sex, marital status, age (provided the applicant has the capacity to
enter into a binding contract); because all or part of the applicant's income derives from any public assistance
program; or because the applicant has in good faith exercised any right under the Consumer Credit Protection
Act. The Federal agency that administers compliance with this law concerning this creditor is FDIC Consumer
Response Center, 1100 Walnut Street, Box #11, Kansas City, MO 64106.
If property is used as collateral, it must be insured on the day of closing. The amount of insurance coverage must
be equal to the lesser of the insurable value or the loan amount. You have the right of free choice in the selection
of the agent and insurer through or by which the insurance is to be placed.
If the loan is secured by a first lien on a residential property, we will order an appraisal to determine the property’s
value and charge you for this appraisal. We will, promptly after our review, provide you a copy of any appraisal,
even if your loan does not close. You can pay for an additional appraisal for your own use at your own cost.
Regulation B requires delivery of the residential appraisal three days prior to closing. You may waive this three
day requirement by completing a waiver form at least three days prior to closing.
You have the right to a copy of the commercial appraisal report used in connection with your application for
credit. If you wish a copy, please write to us at the mailing address we have provided below. We must hear from
you no later than 90 days after we notify you about the action taken on your credit application.
If your loan is denied, you have the right to a statement of specific reasons if requested within 60 days of our
notification of adverse action. We will send you the written notice within 30 days of your request. Please contact
your Lender for more information.
This notification is provided to you in conjunction with the current loan request(s) and is applicable to any and
all requests or subsequent agreements hereafter arising, including, without limitation, to any amendments,
renewals, or extensions of the note or other documents associated with the transaction.
Bangor Savings Bank
Attn: Commercial Banking
PO Box 930
Bangor, ME 04402-0930
Effective Date: 05/01/2018
CERTIFICATION OF BENEFICIAL OWNER(S)
All persons opening an account on behalf of a legal entity must provide the following information:
Full Name and Title (person completing form)
Borrower Name
Legal Entity Name
Legal Entity Type (corporate structure)
Legal Entity Address
INSTRUCTIONS: If there are no Legal Entities involved in this loan transaction, please complete ONLY Section III.
Otherwise, complete all sections of this form. Please see General Instructions page for further information.
SECTION
I – BENEFICIAL OWNERS
Please provide the following information for each individual(s), if any, who directly or indirectly, through any contract
arrangement, understanding, relationship, or otherwise owns 25% or more of the equity interests of the legal entity listed
above. Check here ☐ if no individual meets this definition and complete Sections II and III.
Full Name
Ownership %
SECTION II - CONTROL
Please name an individual with significant responsibility for managing or directing the entity, including, an executive officer
or senior manager (e.g. Chief Executive Officer, Chief Financial officer, Chief Operating Officer, Managing Member, General
Partner, President, Vice President, Treasurer); or any other individual who regularly performs similar functions.
Full Name
Title
I, _
__________________________________ (name of person opening account), hereby certify, to the best of my
knowledge, that the information provided above is complete and correct. I further certify that the Borrower will provide
the Bank with updated information if any of the above reported information changes.
Signature: Date:
Title:
SEC
TION III – PAYMENT METHOD (NEW LOANS ONLY)
Please indicate the payment method anticipated for the new loan:
☐
AFT
☐ EFT
☐
CASH
☐
CHECK
☐
WIRE
☐
ONLINE PAYMENT
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signature
click to edit
Effective Date: 05/01/2018
GENERAL INSTRUCTIONS
What is this form?
To help the government fight financial crime, Federal regulation requires certain financial institutions to obtain, verify, and
record information about the beneficial owners of legal entity customers. Legal entities can be abused to disguise
involvement in terrorist financing, money laundering, tax evasion, corruption, fraud and other financial crimes. Requiring
the disclosure of key individuals who own or control a legal entity (i.e., the beneficial owners) helps law enforcement
investigate and prosecute these crimes.
Who has to complete this form?
This form must be completed by any person opening a new account on behalf of a legal entity. Additionally, Section III of
this form must be completed for all new loans, regardless of legal structure. Finally, for those loans that are renewed after
May 1, 2018, this form must be completed at the time of the first renewal.
For the purposes of this form, a legal entity includes a corporation, limited liability company, or other entity that is created
by a filing of a public document with a Secretary of State or similar office, a general partnership, and any similar business
entity formed in the United States or a foreign country. Legal entity does not include sole proprietorships, unincorporated
associations, or natural persons opening accounts on their own behalf.
What information do I have to provide?
When you open a new account on behalf of a legal entity, we will ask for information about the legal entity’s beneficial
owner(s). Beneficial owners will be required to complete a Customer Identification Policy (CIP) Form prior to loan closing.
Beneficial owners are:
1. Each individual, if any, who owns, directly or indirectly, 25 percent or more of the equity interests of the legal
entity customer (e.g., each natural person that owns 25 percent or more of the shares of a corporation); and
2. An individual with significant responsibility for managing the legal entity customer (e.g. Chief Executive Officer,
Chief Financial officer, Chief Operating Officer, Managing Member, General Partner, President, Vice President,
Treasurer)
The number of individuals that satisfy this definition of “beneficial owner” may vary. A legal entity may have multiple
beneficial owners. This form requires you to list only those that own 25% or more. If appropriate, the same individuals
may be listed under both Section I and Section II.
Borrowers are also required to indicate the anticipated method of payment in Section III.
PO BOX 930
Bangor, ME 04402-0930
207.942.5211
AUTHORIZATION TO RELEASE INFORMATION
To:
RE:
Account or other indentifying number, if applicable
Account Balance:
Name:
I/We hereby authorize you to provide Bangor Savings Bank for verification purposes the following applicable
information (check all that apply):
Payoff amount for the account number identified above; as of payoff date: ______________________
Copies of tax return information, accountant prepared financial statements and supporting documents
Bank account, stock holdings and any other asset balances
Past and present employment or income records
Other credit references
You are authorized to release the above information after the date of this authorization and until receipt of
written notice of revocation of this authorization. A copy of this authorization may be accepted as an
original.
Print Name Print Name
Signature Signature
Date Date
click to sign
signature
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signature
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AUTHORIZATION TO RELEASE INFORMATION
Purpose
The Authorization to Release Information form is intended solely for business purpose loans. Its primary
purpose is to document a Business Banking client’s authorization, to permit the release of information by a third
party to the bank.
Pre Closing
On a pre-closing basis, the authorization form is used primarily to obtain a payoff quote from a financial
institution, for a bank loan or credit card account to be refinanced by BSB. An authorization should be
completed for each account being refinanced and signed by the authorized signer or individual.
The authorization does not address requests for reports from consumer reporting agencies; therefore, it must be
used in conjunction with the Business Loan Application and Personal Financial Statement for the appropriate
credit reporting disclosures.
Closing
At closing (or post closing), the authorization form is used primarily to allow the bank to gather financial
statements required as a condition of a loan, directly from a third party (such as an accounting firm or tax
preparer).
Use of the form by the client is optional. If the client opts to use the form, the client authorizes release of
information, after the date of authorization and until written notice of revocation of the authorization is received
by the third party. The client may use one form for each Borrower and Guarantor, to be signed by the authorized
signer or individual.
Tracking Authorization for Financial Statements
A copy of the completed, signed form can be provided to the accounting firm by the bank.
For documentation purposes, the completed authorization should be maintained with the relationship file.
For tracking purposes, a Tickler must be set up in Baker Hill One Point, indicating the signature date of the
authorization (in the Date and Due Date) fields.
Form Instructions
In the first section, input the following:
To: Name of accounting firm/tax preparer; Financial institution or reference
RE: Account or other indentifying number (required for payoff quote)
Account Balance: Balance of account identified above (required for payoff quote)
Name: Borrower Name, Guarantor Name; Applicant Name
In the second section, indicate what information will be released:
Copies of tax return information, accountant prepared financial statements and supporting documents
Bank account, stock holdings and any other asset balances – (this is what you check for a payoff)
Past and present employment or income records
Other credit references
GMI Data Form Rev. 1/2018 Page1 of 2
H M D A G M I D A T A F O R M
INSTRUCTIONS
Applicant Name: __________________________________________
Must be an individual applicant (not guarantors)
PURPOSE OF LOAN [to be completed by lender]
Review each option below and check appropriately:
1. Purchase: Purchase of home or dwelling where the loan is secured by a dwelling or a construction to permanent financing of a
dwelling to be built Yes ☐ No ☐
2. Refinance: Payoff of existing loan secured by a dwelling and new loan also secured by a dwelling Yes ☐ No ☐
3. Home Improvement: Home improvement loan secured by a dwelling Yes ☐ No ☐
If you have answered NO to ALL of the questions, the application is not covered by HMDA, and you cannot collect the monitoring
information.
If you have answered YES to ANY of the above, have the customer read the disclosure and have the customer complete the form
below. If the application is taken by telephone, you must read the disclosure below to the applicant and ask for the information.
Note the applicant’s responses. The applicant may provide multiple race categories. Record each one provided. If the customer
chooses not to furnish the information in a face-to-face application, you must note the information based on visual observations or
surnames.
If a customer chooses not to provide the information in an application taken by telephone, you do not have to provide the
information or collect it later.
For customers that are not natural persons (e.g., business entities), enter the customer name and write “NA” across the
form. Do not complete for guarantors.
GMI Data Form Rev. 1/2018 Page 2 of 2
The purpose of collecting this information is to help ensure
that all applicants are treated fairly and that the housing
needs of communities and neighborhoods are being fulfilled.
For residential mortgage lending, Federal law requires that
we ask applicants for their demographic information
(ethnicity, race, and sex) in order to monitor our compliance
with equal credit opportunity, fair housing, and home
mortgage disclosure laws. You are not required to provide
this information, but are encouraged to do so. You may
select one or more designations for “Ethnicity” and one or
more designations for “Race.”
The law provides that we may not discriminate on the basis of
his information, or on whether you choose to provide it.
However, if you choose not to provide the information and you
have made this application in person, Federal regulations
require us to note your ethnicity, race, and sex on the basis of
visual observation or surname. If you do not wish to provide
some or all of this information, please check below.
Applicant: ________________________________________
Co-Applicant: ________________________________________
Ethnicity: – Check one or more
Ethnicity: – Check one or more
☐Hispanic or Latino
☐Hispanic or Latino
☐Mexican
☐Mexican
☐Puerto Rican
☐Puerto Rican
☐Cuban
☐Cuban
☐
Other Hispanic or Latino – Print origin, for example,
Argentinean, Colombian, Dominican, Nicaraguan, Salvadoran,
Spaniard, and so on:
☐
Other Hispanic or Latino – Print origin, for example, Argentinean,
Colombian, Dominican, Nicaraguan, Salvadoran, Spaniard, and so
on:
☐
Not Hispanic or Latino
☐Not Hispanic or Latino
☐I do not wish to provide this information
☐
I do not wish to provide this information
Race: – Check one or more
Race: – Check one or more
☐American Indian or Alaska Native – Print name of enrolled or
principal tribe:
☐American Indian or Alaska Native – Print name of enrolled or
principal tribe:
☐Asian
☐Asian
☐Asian Indian
☐Asian Indian
☐Chinese
☐Chinese
☐Filipino
☐Filipino
☐Japanese
☐Japanese
☐
Korean
☐
Korean
☐Vietnamese
☐Vietnamese
☐
Other Asian – Print race, for example, Hmong, Laotian,
Thai, Pakistani, Cambodian, and so on:
☐
Other Asian – Print race, for example, Hmong, Laotian, Thai,
Pakistani, Cambodian, and so on:
☐Black or African American
☐
Black or African American
☐Native Hawaiian or Other Pacific Islander
☐Native Hawaiian or Other Pacific Islander
☐
Native Hawaiian
☐
Native Hawaiian
☐Guamanian or Chamorro
☐Guamanian or Chamorro
☐Samoan
☐Samoan
☐
Other Pacific Islander – Print race, for example, Fijian,
Tongan, and so on:
☐
Other Pacific Islander – Print race, for example, Fijian,
Tongan, and so on:
☐
White
☐
White
☐I do not wish to provide this information
☐I do not wish to provide this information
Sex:
Sex:
☐Female
☐Female
☐Male
☐Male
☐I do not wish to provide this information
☐I do not wish to provide this information
To Be Completed by Financial Institution (for an application taken in person):
Was the ethnicity of the applicant collected on the basis of visual
observation or surname?
Was the ethnicity of the co-applicant collected on the
basis of visual
observation or surname?
☐Yes
☐Yes
☐
No
☐
No
Was the race of the applicant collected on the basis of visual
observation or surname?
Was the race of the co-applicant collected on the basis of visual
observation or surname?
☐Yes
☐Yes
☐
No
☐
No
Was the sex of the applicant collected on the basis of visual
observation or surname?
Was the sex of the co-applicant collected on the basis of visual
observation or surname?
☐
Yes
☐
Yes
☐No
☐No
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2018 09 Business Loan Application And Agreement Packet (Bangor Savings Bank)

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Completed 16 July 2020

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