business loan application
borrower
Borrower Name
Mailing Address
City State Zip
Contact
Phone Fax
Email
Tax ID or SS#
Date Established NAICS Code and D&B Number
Business Description
Legal Status of Company
Corporation
Sub S-Corp
Professional Corp
Nonprofit Corp
Limited Liability Corp
Sole Proprietorship
Limited Partnership
General Partnership
Limited Liability Partner
Other:
Ownership/Partners
Name Ownership %
Purpose of Loan Request
(subject to program guidelines)
Real Estate Equipment
company (complete if different from borrower)
Company Name
Mailing Address
City State Zip
Contact
Phone Fax
Email
Tax ID or SS#
Date Established NAICS Code and D&B Number
Business Description
Legal Status of Company
Corporation
Sub S-Corp
Professional Corp
Nonprofit Corp
Limited Liability Corp
Sole Proprietorship
Limited Partnership
General Partnership
Limited Liability Partner
Other:
Ownership/Partners
Name Ownership %
Purpose of Loan Request
(subject to program guidelines)
Real Estate Equipment
costs
description cost $
Land
Acquisition/Construction
Rehabilitation
Equipment (describe at right)
Other
Total
Less Equity (minimum 10%)
Loan Request
equipment description
new used
new used
new used
new used
new used
new used
new used
new used
staffing
description
total number
full time part time
Current Employees
Average Annual Wage of Employees
Total New Positions to be Added
Average Wage of New Positions
benefits
Medical full time part time
Dental full time part time
Savings/401k full time part time
Paid Vacation full time part time
Tuition Reimbursement full time part time
Paid Sick Leave full time part time
Other:
full time part time
04/14.v9
page 1 of 3
$0.00
$0.00
complete for real estate loans
Real estate applications must be accompanied by one of the following: Title Policy Warranty Deed Purchase Contract
Project Address County
City State Zip
Acquisition Date Square Footage of Building Name of Construction or Interim Lender
Do you intend to lease out any space? (If yes, applicant must provide a copy of lease.) Have any of the following been ordered?
Yes No
Phase 1 Appraisal Title Policy Survey
What are your plans for your existing location? (lease expiration date, sales prospects, etc.)
owner information
Race Ethnicity Gender
American Indian/Alaskan Native
Asian
Black/African American
Native Hawaiian/Other Pacific Islander
European
Other
Hispanic or Latino
Not Hispanic or Latino
Female
Male
application checklist The following information is required with the application.
Most recent three years’ historical financial statements and tax returns
(including balance sheets and income statements)
Most recent tax return from all individuals with an ownership interest
of 20% or greater
Business plan may be required
(must include business description, products or services, business production plan,
market analysis or marketing plan, organization/management plan, and financial plan)
An interim financial statement no more than 90 days old
Personal Financial Statement (one is provided with the application)
Project Plan (one is provided with the application)
Projected financial statements for two (2) years may be required
(including balance sheets and income statements)
Name and phone number of insurance agent (complete information below)
Name of Insurance Agent Phone Number of Insurance Agent
other information
Have you or any officer of your company ever been involved in bankruptcy or insolvency proceedings?
Yes No
Have you or any officer of your company ever been under indictment, parole, or probation?
Yes No
Have you or any officer of your company ever been convicted of any criminal offense other than a minor traffic violation?
Yes No
Have you or any officer of your company ever defaulted on SBA, CHFA, Federal, or State financing?
Yes No
Are you, any officer of your company, or your business involved in any pending lawsuits?
Yes No
signatures
By signing below I (a) confirm that all of the information provided in this application is true and correct and (b) acknowledge that I have read
and understand the disclaimers and information on the following page.
Signature
Title
Date
Signature
Title
Date
page 2 of 3
nondiscrimination and affirmative action
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 applicants 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 the Federal Trade Commission, Equal Credit Opportunity, Washington, D.C. 80580.
With respect to its programs, services, activities, and employment practices, Colorado Housing and Finance Authority does not discriminate on the basis
of race, color, religion, sex, age, national origin, disability, or any other protected classification under federal, state, or local law. Requests for reasonable
accommodation, the provision of auxiliary aids, or any complaints alleging violation of this nondiscrimination policy should be directed to the Nondiscrimination
Coordinator, 1.800.877.2432, TDD/TTY 303.297.7305, CHFA 1981 Blake Street, Denver CO 80202-1272, available weekdays 8:00am to 5:00pm.
authorization/certification
As a political subdivision of the State of Colorado working to create opportunities for a better Colorado, Colorado Housing and Finance Authority (CHFA)
reserves the right to publicize financing under its Business Finance Division. If provided a loan or other financing through one of CHFA’s Commercial
programs, the borrower or sponsor authorizes the use of the development, owner, sponsor, and/or business name in the marketing of this program.
The applicant authorizes any insurance agent or company to provide copies of policies of insurance with respect to the Project, borrowers or guarantors,
including without limitation copies of any life insurance policies.
I/we certify that at least 51% of the outstanding interest in the business is owned by those who are either citizens of the United States or reside in the United
States after being legally admitted for permanent residence. I/we also guarantee the above and enclosed information to be true and correct. I/we also
understand that intentional misrepresentation of facts may be the basis for a denial of credit. I/we authorize you to check my/our personal and company
credit information.
As a political subdivision of the State of Colorado, CHFA is subject to the Colorado Open Records Act (CORA) C.R.S. §§ 24-72-201, et seq., which requires
CHFA to permit inspection and copying of certain public records. Applicants should be aware that documents submitted to CHFA pursuant to this loan
application may be subject to inspection by the public. If an Applicant believes that certain information included in the loan application is subject to
exclusion under CORA, the Applicant should specifically delineate such information and state the specific exclusion. CHFA shall consider such statements in
its response to requests for inspection under CORA. CHFA will notify the Applicant if a request is made for such information so that the Applicant may take
any action it deems necessary to defend against the request. The Applicant, not CHFA, shall be the entity responsible for defending against CORA disclosures
for any records.
important information
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 financial institutions to obtain, verify, and record information that identifies each person who opens an account. When you
apply for an SBA 504 loan, we will ask 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.
The following uses and activities shall not be conducted in or on the Project: Activities which are illegal under federal, state, or local laws; selling,
producing, or displaying sexually oriented material (e.g., adult book stores, adult video stores, adult theaters, etc); non-medical massage services; a business
generating greater than twenty-five percent (25%) of its revenues from the sale of alcoholic beverages not manufactured on-site or from selling alcoholic
beverages for consumption off premises; a business or organization that discriminates in its membership or facility usage on the basis of race, color, national
origin, religion, gender, age, disability, citizenship status, marital status, sexual orientation, or any other status protected by law; gambling activities (not
including sale of state sanctioned lottery tickets); selling or dispensing products illegal under federal, state or local laws; religious services, instruction of
overtly sectarian activities; pawn brokering; making “payday” or short term loans by an entity that is not a bank, credit union, savings and loan or other
banking institution; and escort services.
page 3 of 3