Purpose of Loan
Working Capital
Equipment
Real Estate
Expansion
Other:
Requested Amount
Desired Term (Months/Years)
Collateral Offered
Legal Business Name
Trade Name (DBA)
Business Address
City
State/Province
Postal/Zip Code
Phone Number
Business Structure
Sole Proprietorship
Partnership
Limited Liability Company (LLC)
Corporation (C-Corp/S-Corp)
Date Established
Industry/Sector
Tax Identification Number
List all owners with 20% or more stake.
Name | Title | Ownership % | Social Security/ ID Number | ||
|---|---|---|---|---|---|
A | B | C | D | ||
1 | |||||
2 | |||||
3 | |||||
4 | |||||
5 |
Annual Gross Revenue
Net Profit (Last Fiscal Year)
Existing Business Debt
Lender Name
Current Balance
Monthly Payment
Number of Employees
Full-time
Part-time
Brief Description of Business Operations: (Include what you sell, who your target customers are, and your primary competitive advantage.)
Use of Funds: (Provide a detailed breakdown of how the loan proceeds will be spent.)
To process this application, please attach the following:
Document Name | Check | Upload File | ||
|---|---|---|---|---|
A | B | C | ||
1 | Business Financial Statements: Balance Sheet and P&L (last 2–3 years). | |||
2 | Tax Returns: Business and Personal (last 2–3 years). | |||
3 | Bank Statements: Last 6 months of business operating accounts. | |||
4 | Legal Documents: Articles of Incorporation, Business Licenses, Leases. | |||
5 | Debt Schedule: Detailed list of all current loans and lines of credit. |
Is the business or any owner a party to any lawsuit or legal action?
Has the business or any owner ever filed for bankruptcy?
Are there any tax liens against the business or owners?
Authorization: The undersigned certifies that all information provided in this application is true and complete. The applicant authorizes the Lender to verify any information provided and to obtain credit reports for the business and its owners.
Signature of Authorized Representative
Form Template Insights
Please remove this form template insights section before publishing.
The Loan Request Summary is placed at the very top for immediate clarity. In a business context, the most important data points are "How much?" and "For what?" By capturing the amount and purpose upfront, the rest of the form serves as the evidence to justify those initial numbers.
The Company Information section establishes the identity of the applicant.
Lenders rarely look at a business in isolation; they look at the people behind it. The Ownership & Key Management section identifies the stakeholders. Requiring a threshold (like 20%) ensures that the form captures the primary decision-makers without becoming cluttered by minor shareholders.
The Financial Overview isn't just about how much money the business makes; it’s about "debt capacity."
The Business Profile & History section is where the applicant tells their story.
The Documentation Checklist turns the form from a simple questionnaire into a comprehensive package. It serves as a "to-do list" for the applicant, ensuring that when the form is submitted, it is accompanied by the necessary proof (bank statements, tax records) to verify the claims made in the digital fields.
The Declarations section is a standard honesty check. It forces the applicant to disclose any significant hurdles or past financial troubles. This saves time by surfacing potential "deal-breakers" early in the review process.
Mandatory Questions Recommendation
Please remove this mandatory questions recommendation before publishing.
To configure an element, select it on the form.