BUSINESS INFORMATION
Business Applicant’s Name (exact legal name)
DBA (if applicable)
Taxpayer ID Number
Year Business Established
Years Current Ownership
Years Owners have been in this
line of business
Annual Sales
$
Business Type:
INDIVIDUAL
Sole Proprietorship
Individual
CORPORATION
Sub-S Corporation
C-Corporation
Limited Liability Company
PARTNERSHIP
General Partnership
Limited Partnership
Limited Liability Partnership
OTHER
Nonprofit Organization
Professional Association
Other
Description of Business or Service
Business Contact Name
Business Phone
( ) -
Business Fax
( ) -
BUSINESS LOCATION (cannot be a P.O. b ox):
Street Address
City
State Zip Code
BUSINESS MAILING ADDRESS (if different from above):
Street Address
City
State Zip Code
LOAN REQUEST
LOAN TYPE:
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$
or increase Line from $ to $
Term Loan Amount Requested
For equipment purchase, please provide the purchase price
$
$
Length of Term:
Also, please include a copy of the purchase order.
Commercial Real Estate Loan* Amount Requested
Owner Occupied:
Investment:
$
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$
Length of Term:
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$ Length of Term:
Description of Other:
*For Commercial Real Estate Loan, please complete and include a REAL ESTATE ADDENDUM form. By signing this application, applicant attests that information provided on
the Real Estate Addendum is true and correct.
LOAN PURPOSE & COLLATERAL
What are loan proceeds going to be used for:
*Collateral Available:
*Loans will be secured by all business assets unless specific assets, acceptable to the Credit Union, are pledged. Please describe fully any such specific assets that you wish to use as
*collateral. Please note which assets, if any are pledged as collateral for other loans. Please note location of collateral if different than your business location.
FINANCIAL INFORMATION
Business Deposit Accounts
Financial Institution Type of Account Current Balance Average Balance Would you like to move the account to KPCU?
$ $ Yes
$ $ Yes
$ $
Yes
Business Debts (List all business debts, including accounts and trade payables. Include existing KPCU debt.)
To whom payable? Type of Account (Revolving, Term, etc.) Balance Owing Payment Pay off with proceeds?
$ $ Yes
$ $ Yes
$ $ Yes
$ $
Yes
RELATED BUSINESS ISSUES
Has the Applicant or any Guarantor or Co-applicant ever declared bankruptcy? Yes No
Is the Business Applicant or any Guarantor or Co-applicant a party to any claim or lawsuit?
Yes No
Are there any state or federal tax liens filed against the Business Applicant or any Guarantor or Co-applicant?
Yes No
Does Business Applicant own or lease occupied building?
Own Lease Is the Business already pledging any assets for a loan or lease? Yes No
If you lease, name lessor:
Mailing address of lesser:
Years remaining on lease:
Monthly lease payments, if applicable: $
OWNERSHIP/MANAGEMENT INFORMATION
List all owners of the company
Name Social Security # Title Percent Ownership
Number of Years in This
Line of Business
Monthly Housing
Payment
%
%
%
%
FINANCIAL STATEMENTS AND TAX RETURNS Please provide a copy of the company’s financial statements or tax returns for the last three years and interim financial
statements for the current year. Please also provide guarantors’ tax returns for the last three years and updated personal financial statements.
AUTHORIZATION: Each Business Applicant and each person or entity signing this Application or an Application Addendum Form (“Signer”) certifies that all information provided by the Business Applicant and
the Signer is true and complete and authorizes KPCU to 1) obtain credit and employment information about the Business Applicant a
nd Signer; 2) obtain credit reports and make any inquiries KPCU considers
appropriate in connection with this application or review of this loan account from time to time; 3) make KPCU experience with this loan account and information about this application available to credit
bureaus, other Signers or other persons who have or expect to have financial dealings with the Business Applicant and the Signer; 4) share collection information with Signer’s other creditors; and 5) disclose
account information as required by
law. Each Signer acknowledges that additional information may be required in order to make a final credit decision. Business Applicant also acknowledges receipt of the
Equal Credit Disclosures provided with this application.
REQUIRED SIGNERS: All signers must also be duly authorized to sign on behalf of applicant.
ACKNOWLEDGEMENT:
EACH SIGNER ACKNOWLEDGES THAT KPCU MAY RELY ON THE STATEMENTS AND INFORMATION SET FORTH IN THIS APPLICATION AND THAT SUCH STATEMENTS AND
INFORMATION MAY BE INCORPORATED BY
REFERENCE IN ANY AGREEMENT ANY OF THE UNDERSIGNED MAY ENTER INTO WITH KPCU. EACH OF THE UNDERSIGNED HEREBY AGREES TO NOTIFY KPCU
PROMPTLY OF ANY CHANGE IN ANY SUCH STATEMENT OR INFORMATION. EACH SIGNER HAS READ AND UNDERSTOOD THE TERMS OF THIS APPLICATION, INCLUDING ANY ADDENDUM, AND
REPRESENTS AND WARRANTS THAT THE INFORMATION CONTAINED HEREIN IS TRUE AND CORRECT. KPCU is KeyPoint Credit Union.
X
Authorized Signature Print Name Title Date
X
Authorized Signature Print Name Title Date
Signature of Guarantors: (Each Shareholder, Partner, or Member owning 20 percent or more interest in the Business Applicant, sign below)
X
Authorized Signature Print Name Title Date
X
Authorized Signature Print Name Title Date
BUSINESS LOAN APPLICATION
Each shareholder, partner or member owning 20 percent or more interest in the Business Applicant must sign a personal guaranty.
A minimum of 1 guarantor is required regardless of percent ownership. Additional guaranties may be required.
