Fillable Small Business Loan Application Checklist Application for Small

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Small Business Loan Application Checklist Application for Small

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Application for Small Business Loan
PAGE 1 OF 7
LOUISIANA
Thank you for your interest in applying for a small business loan from TruFund Financial Services, Inc. (TruFund Financial).
In order for us to give full consideration to your loan request, please submit the following:
It is customary for TruFund Financial staff to request additional information during the loan review process. Commonly-requested materials
include but are not limited to: federal corporate tax returns for any affiliate business entities; monthly financial statements; accounts
receivable and accounts payable aging reports; quarterly sales tax reports; financial projections; recent business credit card and loan/line of
credit statements; copies of contractor bid(s) or contract (for leasehold improvements/construction projects).
If you have any questions or need assistance with completing the forms or compiling the required materials,
please contact us at (504) 293-5550. We look forward to working with you.
Please send materials to: Small Business Loan Fund Manager
TruFund Financial Services, Inc. Gulf Coast
935 Gravier St., Suite 1120
New Orleans, LA 70112
General
FINANCIAL STATEMENTS
OTHER BUSINESS INFORMATION
GUARANTOR(S)
1. Completed and signed TruFund Financial Application for Small Business Loan
2. $250 loan application fee (check made out to “TruFund Financial Services, Inc.”)
1. Audited financial statements for prior three years and any subsequent quarters to date whether audited or unaudited. If audited
financial statements are not available, submit federal corporate tax returns for prior three years and interim financial statements
(profit and loss statement, balance sheet, statement of cash flows [if available]) for any subsequent quarters to date.
2. Copies of business bank statements for prior three months.
1. Copy of current lease
2. Business loan promissory note(s) for all existing debt
3. Corporate documents (Certificate of Incorporation or Articles of Organization, and By-Laws or Operating Agreement)
4. Insurance Certificates for business insurance (Worker’s Compensation and Employer’s Liability, Disability,
and Commercial General Liability)
5. Business plan (if available)
TruFund Financial requires personal guaranties from each individual owning 20% or more of the business. Guaranties may also be
requested from third parties during the loan review process. Please submit the following for each guarantor:
1. Completed and signed Personal/Joint Financial Statement
2. Copies of personal federal tax returns for prior three years.
3. Copy of official photo identification (e.g. driver’s license)
Small Business Loan Application Checklist
Materials may be
sent by email to:
The Application will be reviewed once the application fee has been processed.
David Buggage
dbuggage@trufund.org
or
Larry Dents
ldents@trufund.org
Application for Small Business Loan
PAGE 2 OF 7
Section 1: Business Information
Name (of Individual): Contact Phone #:
City: State: Zip: Fax:
Year Business Established: Years in Operation: Years under Current Ownership:
Business Street Address: Phone:
Neighborhood: Business Website:
Business Legal Name: Federal Tax ID/EIN #:
Title (of Individual): Email Address:
Brief Description of Business:
How did you hear about TruFund Financial (i.e., newspaper, friend)?
If you were referred by another organization, which organization?
Primary Products or Services:
Does the Business have all necessary licenses and permits to operate? Yes No
Does the Business currently have any loans or lines of credit from a bank? Yes No
Does the Business have a Board of Directors? Yes No
Have you ever led for personal bankruptcy? No Yes If yes, Type & Date Filled:
Has the Business ever led for bankruptcy? No Yes If yes, Type & Date Filled:
Does the Business have an Advisory Board? Yes No
Do you have any accounts in collection, judgments or unpaid taxes led against you personally? No Yes
Does the Business or any of its owners hold an equity stake of more than 10% in another business entity? Yes No
If yes, please attach a list of related entities and a description of any intra-company transactions.
What was the Business’s gross revenue for prior year? $
What was the Business’s net income (i.e. protor loss) for prior year? $
Business Location:
Legal Entity:
Industry:
Business accounting records prepared by:
Home
C-Corp
Ofce Building
S-Corp
Food/Restaurants
Professional/CPA
Manufacturing
Partner/Employee
Retail
Spouse
Services
Self Not Kept
Storefront
LLC Partnership Sole Proprietor
Other:
Other:
Other:
D/B/A Name (if applicable): ___
Section 2: Loan Request (Estimated amounts are acceptable. Please attach additional detail if necessary)
Section 3: Credit & Financial History (Please attach an explanation for any question answered “Yes”)
USES OF LOAN PROCEEDS
Purchase/develop real estate
Perform leasehold improvements/renovation
Finance sales/marketing initiative
Purchase equipment/inventory
Finance hiring activity
Re-location
Other working capital (general operating expenses)
AMOUNT REQUESTED
Total Amount Requested: $ Requested Loan Term (6-60 months): months
$
$
$
$
$
$
$
$
Other (specify):
Application for Small Business Loan
PAGE 3 OF 7
Section 4: Banking Information & Debt Schedule
Section 5: Demographic & Impact Data
BUSINESS OWNERSHIP
BUSINESS DEPOSITORY ACCOUNTS (attach additional sheets for further detail if necessary.)
EXISTING BUSINESS DEBT
Name of Creditor Loan #
Type (e.g. loan, line
of credit, credit card
Date
Opened
Name % Ownership Race/Ethnicity Gender
Original
Amount
Veteran
Status
Present
Balance
Living
with a
Disability?
Interest
Rate
Maturity
Date
Monthly
Payment
Current or
Past Due
Purchase/develop real estate
Please supply the following information for all term loans, lines of credit, mortgages, credit cards, equipment leases, etc.
Attach additional sheets with further detail if necessary.
This information is used to record the demographics and measure the impact of assistance provided by TruFund Financial.
It is used internally and reported to funding sources only in the aggregate.
Please list each individual owning 20% or more of the Business.
Account Number
Average Balance
$
$
$ $ $%
%
%
%
$ $ $
$ $ $
$ $ $
Have any Federal or State tax liens ever been led against your business?
Has your business ever been sued or is it currently being sued?
Have you ever been personally sued or are you currently being sued?
Have you or your Business defaulted on any loans?
Have you ever been convicted, charged or indicted for a felony?
Section 3: Credit & Financial History (Please attach an explanation for any question answered “Yes”) (continued)
No
Asian-Indian Subcontinent
Asian-Indian Subcontinent
Hispanic
Hispanic
Asian-Pacic
Asian-Pacic
Native American
Native American
Black/African American
Black/African American
White
White
Other:
Other:
Yes
No Yes
No Yes
No Yes
Female
Yes Yes
Yes Yes
Female
No Yes
Male
No No
No No
Male
Application for Small Business Loan
PAGE 4 OF 7
Section 6: Authorization and Certification
Is the Business certied as Minority- or Women-Owned? Minority-Owned Women-Owned
I/We authorize TruFund Financial Services, Inc. (TruFund Financial) and/or its agents to make any investigations of credit either directly or though
any agency, lender, governmental entity or other third-party which has credit or related information. I/We agree that this application and any
attachments shall remain TruFund Financial’s property whether or not the loan is granted. I/We hereby certify that all information contained in this
document and any attachments is true and correct to the best of my/our knowledge. Should it come to my/our attention that any information is
inaccurate I/we will immediately notify TruFund Financial and provide the correct information. In addition, it is understood that neither TruFund
Financial nor its agents will directly benet from this relationship. TruFund Financial does not warrant or guarantee in any manner that its
assistance will result in business success. I/We specically waive and release any claims now or in the future regarding the assistance provided by
TruFund Financial and/or its agents.
Number of Employees (including self), 20_ _:
Jobs Created: Projected New Employees in the Next 12 Months if Financing is Received:
Jobs Retained: Projected Employees Retained if Financing is Received (list only the
number of jobs that would be eliminated if nancing is not received):
Current Wage Range for Hourly Employees (if applicable):
Do all employees receive health benets/insurance?
Number of Employees (including self), 20_ _:
Number of Employees (including self), 20_ _:
If you decreased your workforce in any year, please describe your reasons for doing so (contracting, revenue, etc.):
Full-Time: _ Part-Time: Independent Contractors:_
Full-Time: _ Part-Time: Contractors:_
Full-Time: _ Part-Time: Contractors:_
From $ _ to $ per hour
If no, Please explain:
Full-Time: _ Part-Time: Independent Contractors:_
Full-Time: _ Part-Time: Independent Contractors:_
Name of Individual Completing Application
Name of Other Owner with ≥ 20% Ownership
Name of Other Owner with ≥ 20% Ownership
Name of Other Owner with ≥ 20% Ownership
Name of Other Owner with ≥ 20% Ownership
Signature
Signature
Signature
Signature
Signature
Date
Date
Date
Date
Date
Section 5: Demographic & Impact Data (continued)
Name % Ownership Race/Ethnicity Gender
Veteran
Status
Living
with a
Disability?
Asian-Indian Subcontinent
Asian-Indian Subcontinent
Asian-Indian Subcontinent
Hispanic
Hispanic
Hispanic
Asian-Pacic
Asian-Pacic
Asian-Pacic
Native American
Native American
Native American
Black/African American
Black/African American
Black/African American
White
White
White
Other:
Other:
Other:
Female
Yes Yes
Yes
Yes
Yes
Yes
Yes
Female
Female
Male
No No
No
No
No
No
No
Male
Male
BUSINESS STAFFING (The past three years)
Application for Small Business Loan
PAGE 5 OF 7
Section 7: Personal/Joint Financial Statement
PURPOSE
INSTRUCTIONS
This form helps to demonstrate your personal nancial situation. Because you will be asked to personally guarantee the loan, TruFund
Financial will review your assets, liabilities, and ability to handle additional debt. If you are married, include all joint assets and include the
signature of your spouse.
1. Each person owning 20% or more of the Business should complete a separate Personal/Joint Financial Statement.
2. Do not include any business assets or debt on this form. Business information should be included in Section 4 of this application and in
nancials provided separately as part of the application package.
3. Be sure to include complete detailed information on all open accounts as this statement will be cross-referenced with your credit
report. Incomplete information typically holds up the application review process.
4. If you have any questions about how to ll out this form, please contact us.
Individual Name: Social Security #:
Spouse’s Name (if married): Spouse’s Social Security #:
Percent Ownership of Business (if applicable): % Relationship to Business, if not Owner:
Home Address: Home Phone: ___
City: State: Zip: Cell Phone: ___
ASSETS
Checking accounts/Cash on hand
Savings accounts & CDs
Vehicles (estimate current market value)
LIABILITIES
NET WORTH
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
Yr/Make
Yr/Make
Yr/Make
Tax Refund (See section 3)
Notes Payable (See section 2)
Real Estate (See section 4)
Auto Loans/Leases (See section 2)
Stocks & Bonds (See section 5)
Credit Cards (See section 2)
Other Assets & Personal Property
(See section 5)
Student Loans (See section 2)
Accounts/Notes Receivable
(See section 6)
Other Installment Loans
(See section 2)
IRAs/Retirement accounts
(See section 6)
Mortgages on Real Estate
(See section 3)
Unpaid Taxes (See section 8)
Other Liabilities (See section 9)
Life Insurance-Cash Value only
(See section 7)
Loans on Life Insurance
Accounts Payable
TOTAL ASSETS
TOTAL LIABILITIES
Total Assets - Total Liabilities
Application for Small Business Loan
PAGE 6 OF 7
Section 7: Personal/Joint Financial Statement (continued)
SOURCES OF INCOME
Annual Salary/Wages As guarantor or co-maker
Real Estate Income Legal claims and judgments
Net Investment Income Income/Self employment tax
CONTINGENT LIABILITIES
$ $ $
$ $ $
$ $ $
$ $ $
$ $ $
Other Income Other special debt
TOTAL TOTAL
Self Spouse
SECTION 1: INCOME AND LIABILITIES
SECTION 2: NOTES PAYABLE, AUTO LOANS/LEASES, CREDIT CARDS, STUDENT LOANS & OTHER INSTALLMENT LOAN
(Use attachments if necessary. Each attachment must be identied as part of this statement and signed.)
SECTION 3: REAL ESTATE OWNED
(Use attachments if necessary. Each attachment must be identied as part of this statement and signed.)
SECTION 4: STOCKS & BOND (Use attachments if necessary. Each attachment must be identied as part of this statement and signed.)
SECTION 5: OTHER ASSETS & PERSONAL PROPERTY (List and describe items.)
Name & Address of Noteholder
Name & Address of Property
Number of
Shares
Original
Balance
Title is in
Name of
Name of Securities
Current
Balance
Date
Purchased
Cost
Payment
Amount
Original
Cost
Market Value Quotation/
Exchange
Terms
(Monthly, etc.)
Present
Value
Date of Quotation/
Exchange
Mortgage
Balance(s)
Total Value
Amount of
Payment
How Secured or Endorsed
and Type of Collateral
Status of Mortgage
Application for Small Business Loan
PAGE 7 OF 7
Section 7: Personal/Joint Financial Statement (continued)
SECTION 6: IRAS, RETIREMENT ACCOUNTS & NOTES RECEIVABLE (Describe in detail.)
SECTION 9: OTHER LIABILITIES (Describe in detail.)
SECTION 7: LIFE INSURANCE HELD (Give face amount of policies — name of company and beneciaries)
SECTION 8: UNPAID TAXES
(Describe in detail, as to type, to whom payable, when due, amount, and what, if any property the tax lien attaches.)
The undersigned certies that the above facts are true and accurate statements of FINANCIAL CONDITION AS OF
(date) and further agrees to advise TruFund Financial Services, Inc. (TruFund Financial) immediately if there are material changes in my/our
nancial condition. I/We further authorize TruFund Financial to make any verication of the above information it deems necessary in order
to approve this loan.
Applicant Signature
Spouse Signature (if married)
Date
Date
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Small Business Loan Application Checklist Application for Small

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Completed 5 March 2021

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