Decision Comments:
Approved Denied
Notes:
[ ] NO[ ] YES
Creditor Name
Collateral Offered By Applicant
Description Value Total Liens
Ownership Status for
Applicant
□ Purchase Money
□ Presently Owned
Professional Services
□ Purchase Money
□ Presently Owned
□ Purchase Money
□ Presently Owned
□ Purchase Money
□ Presently Owned
Miscellaneous Information
[ ] YES [ ] NO
[ ] YES [ ] NO
Accounting Firm: Contact Name: Phone # or Email:
Insurance Agency: Contact Name: Phone # or Email:
HAS THE BUSINESS CHANGED NAMES IN THE LAST 5 YEARS?
HAS THE BUSINESS RELOCATED FROM ONE COUNTY TO ANOTHER IN THE PAST 5
YEARS?
IS THE BUSINESS FOR SALE OR UNDER AGREEMENT THAT WOULD CHANGE THE
OWNERSHIP OF THE BUSINESS?
DO YOU HAVE AN UP TO DATE BUSINESS PLAN? (IF SO PLEASE PROVIDE A COPY
WITH YOUR APPLICATION)
HAS THE BUSINESS OR ANY PRINCIPAL/OWNER EVER DECLARED BANKRUPTCY?
IS THE BUSINESS OR ANY PRINCIPAL/OWNER A PARTY TO ANY LIEN OR LAWSUIT?
ARE YOU A MARIJUANA RELATED BUSINESS?
[ ] YES [ ] NO
[ ] YES [ ] NO
[ ] YES
YES
[ ] NO
NO
Required Signatures
By signing below you certify that to the best of your knowledge and belief all information contained on this application and in the accompanying statements and
documents is true and correct. You agree to notify PFCU immediately of any material changes in this application. You also acknowledge that the credit you are
applying for is for a business purpose. You authorize PFCU or its assigns to make inquiries to the Internal Revenue Service, and to provide information concerning
Applicant's credit relationship to business credit reporting and credit bureau agencies and associations and other creditors. This application remains the sole
property of PFCU whether or not the loan is granted. Applicant(s) signing the application is/are indeed authorized to act on behalf of the borrower. Borrower, co-
applicant(s), and guarantor(s), as appropriate grants to the credit union the authority to use reasonable means to verify application information by requesting credit
bureau reports, accessing information about borrower, co-applicant(s), and guarantor(s), as appropriate from other third party information providers, and other
means if applicable. Borrower further grants to credit union the right to share this information with third parties as reasonable in the normal course of doing
commercial lending including sharing this information with a third party for purposes of underwriting the loan.
Applicant Signature Title: Date:
Applicant Signature Title: Date:
ARE THERE ANY DELINQUENT STATE OR FEDERAL TAXES OWED BY THE BUSINESS? [ ] YES
[ ] NO
For Lender's Use Only
Officer No./Name Approved By Committee Date Application Date
Countered Conditional Approval
Applicant Signature Title: Date:
Applicant Signature Title: Date:
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