Fillable Business Application FULL DOC (Pg 1 of 6)

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Business Application FULL DOC (Pg 1 of 6)

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Harvest - 6-23-19 GB
FULL DOC (Pg 1 of 6)
Borrower's Name Co-Borrower's Name
Social Security Number Home Phone (incl. Area code) Social Security Number Home Phone (incl. Area code)
E-Mail Address E-Mail Address
Date of Birth (mm/dd/yy)
Married
Unmarried Date of Birth (mm/dd/yy) Married Unmarried
Separated Separated
Street Address (street, city, state, zip code) Street Address (street, city, state, zip code)
Own Rent $ Per Mo. No. Yrs. Own Rent $ Per Mo. No. Yrs.
Check if Mailing Address is DIFFERENT from Street address
Check if Mailing Address is DIFFERENT from Street address
If different, show Mailing address on page 5. If different, show Mailing address on page 5.
If residing at present address for less than two (2) years, complete the following:
Former Address (street, city, state, zip code) Former Address (street, city, state, zip code)
Owned Rented $ Per Mo. No. Yrs.
Owned
Rented
Per Mo. No. Yrs.
Last College/Tech School Attended Dates (from-to) Last College/Tech School Attended Dates (from-to)
- -
Degree/Certificate Degree/Certificate
Name and Address of Employer Name and Address of Employer
Title/Position Type of Business Title/Position Type of Business
Business Phone (incl. area code) Years on this job
Years in Profession
Business Phone (incl. area code)
Years on this job Years in Profession
If employed in current position for less than two (2) years, complete the following:
Name and Address of Employer Name and Address of Employer
Title/Position Type of Business Title/Position Type of Business
Business Phone (incl. area code) Dates (from-to)
Business Phone (incl. area code)
Dates (from-to)
- -
Yes No If you answer "yes" to any questions 1 through 6, use Continuation Sheet for explanations. Yes No
1. Are there any outstanding judgments against you?
2. Have you ever declared bankruptcy?
3. Have you had property foreclosed upon or given title or deed in lieu?
4. Are you a party to a lawsuit?
5. Are you obligated to pay alimony, child support, or separate maintenance?
6. Are any of your assets held in a trust?
7. Are you a U.S. citizen?
8. Are you a permanent resident alien? If yes, please provide a copy of resident alien ID card
9. If purchase, do you or any member of your family share any property or business
ownership with the seller in any way?
10. Are you a member of the Armed Forces?
11. Are you a member of the Armed Forces Reserves?
Borrower's Signature Date Co-Borrower's Signature Date
Co-Borrower
PERSONAL INFORMATION
ACKNOWLEDGEMENT AND AGREEMENT
Co-Borrower
DECLARATIONS
Co-Borrower
Business Application
RESUME
X
X
Same as Borrower Address
I/We authorize Harvest SBF, LLC and/or Harvest CC,LLC to make inquiries and designate third parties as necessary, on
behalf of Harvest (et al.) and the Small Business Adminstration to verify the accuracy of the statements made in this
application and to determine my/our creditworthiness. I/We authorize and instruct any person or consumer reporting agency
to compile and furnish any information it may have or obtain in response to such credit inquiries. I/We certify the above and
the statements contained in the attachments are true and accurate as of the stated date. These statements are made for the
purpose of obtaining a loan. I/We understand FALSE statements may result in possible prosecution by the U.S. Attorney
General (Reference 18 U.S.C. 1001). I/We authorize the release of this information whether the signature below is an
original or a copy.
Harvest - 6-23-19 GB
FULL DOC (Pg 2 of 6)
As of:
(Date)
Completed Jointly Not Jointly
To provide additional information, please use Continuation Sheet.
Assets Liabilities
Deposit toward purchase held by Amount
$
Bank Account Amount
Loans and Leases, Not Real Estate
Creditor Name Mo. Pymt. Unpaid Balance
Account #
$
$
Bank Account Amount Account # Check if variable rate
Creditor Name
Mo. Pymt. Unpaid Balance
Account #
$ $
Publicly Traded Stocks & Bonds Amount Account # Check if variable rate
(Exclude privately owned co.'s) $ Creditor Name Mo. Pymt. Unpaid Balance
Life Insurance net cash value Cash Value $
Face amount $
$ Account # Check if variable rate
Subtotal Liquid Assets
$ Creditor Name Mo. Pymt. Unpaid Balance
Vested interest in retirement fund $ $
Motor Vehicles (make and year) Market Value Account # Check if variable rate
$ Creditor Name Mo. Pymt. Unpaid Balance
$
Account # Check if variable rate
Credit Card Debt
Other Assets (itemize) Market Value Combined Credit Card Debt Mo. Pymt. Unpaid Balance
$ $ $
Alimony/Child Support/Separate Maintenance
Mo. Pymt.
Owed to: $
Real Estate Mortgage Debt
Type of property 1st Lender Name (personal residence) Mo. Pymt. Unpaid Balance
Address
Account # Check if variable rate
2nd Lender Name (personal residence) Mo. Pymt. Unpaid Balance
Date purchased $
Original cost $ Account # Check if variable rate
Present market value $ Monthly rental income $
Type of property 1st Lender Name Mo. Pymt. Unpaid Balance
Address
Account # Check if variable rate
2nd Lender Name Mo. Pymt. Unpaid Balance
Date purchased
Original cost $ Account # Check if variable rate
Present market value $ Monthly rental income $
Type of property 1st Lender Name Mo. Pymt. Unpaid Balance
Address
Account # Check if variable rate
2nd Lender Name Mo. Pymt. Unpaid Balance
Date purchased
Original cost $ Account # Check if variable rate
Present market value $ Monthly rental income $
Total Monthly Payments $
Total Assets
$
Net Worth $ Total Liabilities
$
Borrower
Co-Borrower
$
$
*use additional sheets if necessary
Property C
PERSONAL ASSETS AND LIABILITIES
Property B
Property A
Business Application
Real Estate Owned
$
$
$ $
$
$ $
$
$
$
$
$
$
$
Complete this form for: (1) each proprietor; (2) general partner; (3) managing member of limited liability company (LLC); (4) each owner of 20% or more of the
equity in the Applicant (if the application is for an SBA loan include the assets of the owner’s spouse and any minor children); and (5) any person providing a
guaranty on the loan.
This Statement and any supporting schedules may be completed jointly by both married and unmarried Co-Borrowers if their assets and liabilities are
sufficiently joined so that the Statement can be meaningfully and fairly presented on a combined basis; otherwise, separate Statements and schedules are
required.
List all outstanding debt; Installment, Auto, Alimony, Child Support, Stock Pledges, etc.
Use Continuation Sheet if necessary. Combine all credit card debt.
Mark liabilities that
will be satisfied upon sale or refinancing of real estate owned.
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Harvest - 6-23-19 GB
FULL DOC (Pg 3 of 6)
Business Name Executive / Mailing Address if other Mo. Rent $ Lease expires
dba:
Primary Business Address
List Additional Business Locations Mo. Rent $ Lease expires
Primary Contact Name
Phone #
Fax #
Mo. Rent paid at this location $
Sq.Ft?
Lease expires Mo/Mo?
Business Tax ID #
E-mail Address
Number of Employees
Date Business Established
Website
Type of Entity (select one) Corporation Partnership Proprietorship Other
Business Type (select one) Retail Service Wholesale
Manufacturing
Construction
Name:
Title: % Owned:
Name:
Title: % Owned:
Name:
Title: % Owned:
Name:
Title: % Owned:
Name:
Title: % Owned:
Name:
Title: % Owned:
Nature of Business:
Types of Products / Services as percentages of total revenue:
Business revenue (Sales) trends in the last 3 years are
Increasing
Decreasing
Stable
Explain what factors have affected your trends:
Business profitability (Net Income) trends for last 3 years are
Increasing
Decreasing
Stable
Explain what factors have affected your trends:
Explain how your company generates business (i.e. advertising, word of mouth, trade shows, etc.). Please be specific.
Who are your key customers and why?
Who are your closest competitors and why? What is your competitive advantage?
If you answer "yes" to any questions, use Continuation Sheet for explanations. Yes No
1. Is the business a party to a lawsuit?
2. Has the business ever been involved in bankruptcy proceedings?
3. Does the business have delinquent federal, state, payroll, sales or other tax liability?
4. Has the business had property foreclosed upon or given title or deed in lieu?
5. If renting, have you failed to pay rent on time for each of the last 12 months?
6. Does the business, its owners or majority stockholders hold other loans with Harvest CC, LLC and/or Harvest SBF, LLC?
7. Does the business, its owners or majority stockholders own or have a controlling interest in another business?
If "Yes", please complete a separate BUSINESS INFORMATION form for each affiliate business.
Borrower
Co-Borrower
Ownership must equal 100%
BUSINESS INFORMATION
OWNERSHIP/OFFICERS/DIRECTORS
Business Application
HISTORY
BUSINESS DECLARATIONS
Sq.Ft.
Sq.Ft.
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Harvest - 6-23-19 GB
Aging
A/R Amount
% of total
A/P Amount % of total
$
Current - 30 days
$
31-60 days $ $
61-90 days $ $
Over 90 days $ $
Total
$ $
Number of Accounts # #
Accounts Receivable representing more than 20%
Account Name
Explanation Outstanding Balance
$
Account Name
Explanation Outstanding Balance
$
Accounts Receivable of over 90 days
Account Name
Collectability/Explanation Outstanding Balance
$
Account Name
Collectability/Explanation Outstanding Balance
$
Account Name
Collectability/Explanation
Outstanding Balance
$
Account Name
Collectability/Explanation
Outstanding Balance
$
Accounts Payable over 90 days
Account Name
Explanation Unpaid Balance
$
Account Name
Explanation Unpaid Balance
$
Account Name
Explanation Unpaid Balance
$
Yes No Yes No Yes No
Yes No Yes No Yes No
Creditor
Original Amount
Original Date
Present Balance
Interest (%) Rate
Maturity Date
Monthly ($) Payment
Collateral/Security
Status (current/pass due)
Variable rate? (yes/no)
Creditor
Original Amount
Original Date
Present Balance
Interest (%) Rate
Maturity Date
Monthly ($) Payment
Collateral/Security Status
(current/past due)
Variable rate? (yes/no)
Borrower
Co-Borrower
Total business debt list should match loans and leases on current business financial statement dated
Loan/Lease 3
Loan/Lease 1
Loan/Lease 2
A/R and A/P totals listed below must correspond to current business financial statement
dated
A/R AND A/P AGING SUMMARY
Loan/Lease 4
Loan/Lease 5
Loan/Lease 6
Business Application
BUSINESS DEBT SUMMARY
FULL DOC (Pg 4 of 6)
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Harvest - 6-23-19 GB
Loan Amount
dba: Application is for Conventional SBA 504 7(a)
Purpose Purchase
Tenant Improvements
Refinance
Purchase Money Loan
Purchase Price Seller Credits Source of Down Payment
$ $
If any part of the down payment is borrowed, complete the following.
Lender Loan Amount Interest Rate Terms
$ %
Tenant Improvement Loan
Improvement Cost
Describe Improvements
$
Construction-Permanent Loan
Yr. Lot Acquired Original Cost Existing Liens Present Value Improvement Cost
$ $ $ $
Refinance Loan
Have all payments been made on time for the last two years?
Yes No
Year Acquired Original Cost Year Improved Improvement Cost Present Value
$ $ $
Existing Liens - Lender Date Made Original Amount Current Balance Term Rate SBA?
$ $
$ $
Cash Out Request
Amount Requested Cash out use.
$
This is a business purpose loan request. How does this loan transaction benefit your business?
Property Address County
# Units Building size Lot size Year built
Construction Type (CTU, frame, block, etc.) Zoning % Occupied Now Property Type (industrial, retail, office, mixed use, etc.)
Describe occupancy upon funding of this loan.
Owner-Occupied % Tenant-Occupied %
Tenant Rent Roll
Unit Occupant Sq.Ft. Mo. Rent Started Expires Options
$
$
$
$
Print Exact Names
Borrower
Co-Borrower
Please identify the factors creating the increase in value.
VESTING OF REAL ESTATE TITLE
Business Application
$
LOAN REQUEST
Business Name
Vacancy %
REAL ESTATE TO BE FINANCED
Company Vesting
FULL DOC (Pg 5 of 6)
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 institutions to obtain, verify, and record information that identifies each
person who opens an account. What this means for you: When you apply for a loan, we will ask you for your name, address, date of birth, and other
information that will allow us to identify you. We may also ask to see your driver's license or other identifying documents.
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Harvest - 6-23-19 GB
Business Application
In order to consider issuing a Loan Commitment Letter, we require the following documents from your files.
Copy(ies) of note(s) to be refinanced and Original Settlement Statement(s)
Transaction documents as available; purchase contract, escrow instructions, preliminary title report.
3 years complete business Federal income tax returns (each business).
3 years complete personal Federal tax returns for each borrower.
Current business Financial Statement to include a balance sheet and a profit and loss statement, less than 60 days old.
Copies of leases for all locations occupied by the business.
Copies of tenant leases for the real estate to be refinanced.
Other items may be required as requested.
Use this Continuation Sheet to add information to Borrower Information
, Business Information, and Loan Request forms.
Business Name Borrower
Co-Borrower
Borrower
Co-Borrower
CONTINUATION SHEET
Text will wrap automatically. To create a new paragraph, press and hold the "ALT" key when pressing "ENTER"
DOCUMENTS ADDITIONALLY NEEDED
FULL DOC (Pg 6 of 6)
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Business Application FULL DOC (Pg 1 of 6)

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Completed 2 June 2021

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