Below is our comprehensive loan application form. Click the Print button on your browser to get a hard copy of the application. After you fill out the form, mail or fax it to us using our contact information. One of our loan staff will call you and set up an appointment to finalize paperwork with a loan officer. Within 48 hours, we will let you know the status of your loan.

Corporate Name/Trade Name

Home Phone

Street Address

Business Phone

City   State   Zip Code

IRS Tax ID #

Mailing Address (if different)   City

State   Zip Code   Type of Business

Ownership in any other business?   Yes   No   Bank of Business Account

# Employees Include Owners & Managers: Before Loan   After Loan   Data Established

Management (Proprietor, partners, officers, directors owning 20% or more of the company)
Must account for 100% of ownership of the business

Have you or any officer of your company ever been involved in bankruptcy or insolvency proceedings? Yes   No  
If yes, provide details to bank.
Are you or your business involved in any pending lawsuits? Yes   No   If yes, provide details to bank.

DESCRIBE YOUR BUSINESS OPERATION

SUMMARY OF MANAGEMENT'S BUSINESS EXPERIENCE, EDUCATION, AND TRAINING:

LOAN REQUEST: HOW MUCH, FOR WHAT, WHY IS IT NEEDED:

INDEBTEDNESS: Furnish information on ALL BUSINESS debts, contracts, notes, and mortgages payable.
Indicate by an (*) items to be paid with loan proceeds.

If applicant is a proprietor or general partner, sign here: By   Title   Date

If corporation sign below:     Corporate Name