• No results found

Belco Community Credit Union BUSINESS LOAN APPLICATION

N/A
N/A
Protected

Academic year: 2021

Share "Belco Community Credit Union BUSINESS LOAN APPLICATION"

Copied!
5
0
0

Loading.... (view fulltext now)

Full text

(1)

Belco Community Credit Union

BUSINESS LOAN APPLICATION

Completed on ______/______/_______

APPLICANT INFORMATION

Applicant Name Tax ID#/SSN

Date Business Established Date of Present Management

Business Phone Business Fax

Credit Request

Applicant Only Joint With Co-Applicant(s)

We intend to apply for joint credit (Initial below):

Applicant__________________ Co-Applicant__________________ Marital Status (If Individual Borrower)

Married Unmarried Separated Check Appropriate Box

If you are applying for individual credit and are relying on your own income or assets and not the income or assets of another person as the basis for repayment of the credit requested, do not complete the section for marital status.

If you are applying for individual credit, but are relying on income from alimony, child support, or separate maintenance or on the income or assets of another person as the basis for repayment of the credit requested, complete all sections to the extent possible, providing information about the person whose alimony, support or maintenance payments or income or assets you are relying.

If you are applying for joint credit with another applicant, complete all sections and attach joint application.

Business Name (if applicable) Nature of Business

Main Contact Name Email Address

Number of Employees Belco Business Account #

Physical Address Mailing Address

Business Entity:

Sole Proprietorship Corporation S-Corporation LLC General Partnership LLP Non-Profit Other:___________

OWNERSHIP AND GUARANTOR INFORMATION

OWNER/GUARANTOR 1: OWNER/GUARANTOR 2:

Name Name

Title % Ownership Title % Ownership

SSN Birth Date SSN Birth Date

Home Address Home Address

City, State, Zip City, State, Zip

Length of Residence: Own Rent Length of Residence: Own Rent

Marital Status: Unmarried Married Separated Marital Status: Unmarried Married Separated

Home Phone Work Phone Home Phone Work Phone

Employer Name Employment Date Employer Name Employment Date

Annual Income Belco Account Number Annual Income Belco Account Number

BUSINESS FINANCIAL INFORMATION (attach additional pages if needed)

Financial Institution Account Number Type of Account or Loan Current Balance Collateral (If Loan)

Belco Community Credit Union Small Business Lending PH: 717-720-6408 Fax: 717-720-6257 449 Eisenhower Blvd. Harrisburg, PA 17111

Page 1 of 2

(2)

BUSINESS FINANCIAL INFORMATION (continued)

Estimated Annual Revenue (Business Operations) Estimated Annual Expenses (Business Operations)

Estimated Annual Revenue (Rental Properties) Estimated Annual Expenses (Rental Properties)

BUSINESS LOAN REQUEST

Amount of Loan Request:

Purchase

Refinance

Term Requested:

Fixed Rate Period:

5 Years 7 Years 10 Years Other_________

Amortization Requested (in years):

5 7 10 15 20 25 Other_________

Type of Business Loan Requested:

1-4 Family Unit Real Estate Line of Credit Vehicle Purchase Commercial Real Estate

Residential Land Term Loan Construction Loan Commercial Land

Purpose of Loan:

Collateral Offered for Loan Reported Value Source of Value Existing Lien Amount (if applicable)

OTHER INFORMATION

(If “yes” to any of the following, please attach explanatory information)

YES NO

YES NO

YES NO

YES NO

YES NO

YES NO

YES NO

1) Is the business applying for credit from another source?

2) Is the business party to a claim or lawsuit?

3) Are there any delinquent FICA or sales taxes?

4) Has the business or principal(s) ever declared bankruptcy?

5) Does the business owe taxes from a prior year?

6) Does the business have other financial obligations?

7) Are any assets, either business or personal, held in a trust?

8) Does any owner own in excess of 20% of any other business? YES NO

AUTHORIZED SIGNERS FOR THIS APPLICANT

I/We hereby apply for a loan or credit described in this application on behalf of the applicant and/or business. I/We certify that I/we made no misrepresentation in this loan application or in any related documents, that all information is true and complete, and that I/we did not omit any important information. I/We agree that any property securing the loan or credit will not be used for any illegal or restricted purpose. Lender is authorized to verify with other parties and to make any investigation of my/our credit, either directly or through any agency employed by the Lender for that purpose. Lender may disclose to any other interested parties information as to Lender’s experiences or transactions with my/our account. I/we understand that Lender will retain this application and any other credit information Lender receives, even if no loan or credit is granted. These representations and authorizations extend not only to Lender, but also to any insurer of the loan and to any investor to whom Lender may sell all or any part of the loan. I/We further authorize Lender to provide any such insurer or investor any information and documentation that they may request with respect to my/our application, credit or loan.

____________________________ ________ ____________________________ ________

Authorized Signer Date Authorized Signer Date

____________________________ ____________________________

Title Title

____________________________ ________ ____________________________ ________

Authorized Signer Date Authorized Signer Date

____________________________ ____________________________

Title Title

(3)

Page 2 of 2

Belco Community Credit Union

INDIVIDUAL FINANCIAL STATEMENT

Belco Community Credit Union Small Business Lending PH: 717-720-6408 Financial condition as of ______/______/_______

Fax: 717-720-6257 449 Eisenhower Blvd. Harrisburg, PA 17111

Page 1 of 2

Belco Community Credit Union – 449 Eisenhower Blvd. – Harrisburg, PA 17111 – Ph: 717-720-6408 – Fax: 717-

720-6257 –

www.belco.org

APPLICANT INFORMATION

Complete this form for (1) each proprietor, (2) each limited partner who owns 20% of more interest and each general partner, or (3) each stockholder owning 20% or more of voting stock, or (4) any person or entity providing a guaranty on the loan.

Applicant Name SSN

Business Name (if applicable) Phone Number H W Cell Home Address

If assets are owned jointly with spouse, please provide name of spouse:

BALANCE SHEET INFORMATION

ASSETS LIABILITIES

Cash in hand and in Banks $ Accounts Payable $

Savings Accounts $ Notes Payable to Banks & Others

(Describe in Section 2)

$

IRA of Other Retirement Account $ Installment Account (Auto)

Monthly payments: $___________

$

Accounts & Notes Receivable $ Installment Account (Other)

Monthly payments: $___________

$

Cash Value of Life Insurance

(Describe in Section 8) $ Loan on Life Insurance $

Stocks & Bonds

(Describe in Section 3)

$ Mortgages on Real Estate

(Describe in Section 4)

$

Real Estate

(Describe in Section 4)

$ Unpaid Taxes

(Describe in Section 6)

$

Automobile(s) – Present Value $ Other Liabilities

(Describe in Section 7) $ Other Assets

(Describe in Section 5)

$

Total Assets $ Total Liabilities $

Net Worth (Difference between total assets

and total liabilities) $

Section 1: SOURCE OF INCOME** CONTINGENT LIABILITIES

Salary $ As Endorser or Co-Maker $

Net Investment Income $ Legal Claims & Judgments $

Real Estate Rental Income $ Provision for Federal Income Tax $

Other Income (Describe below) $ Other Special Debt (Describe below) $

Description of Other Income/Debt in Section 1:

**Alimony or child support payments need not be disclosed in “Other Income” unless it is desired to have such payments counted toward total income. Section 2: NOTES PAYABLE TO BANK AND OTHERS

Name/Address of Noteholder(s) Original Balance Current Balance Payment Amount How Secured – Type of Collateral

(4)
(5)

Page 2 of 2

Section 3: STOCKS AND BONDS

Number of Shares Name of Securities Cost Market Value

Quotation/Exchange

Date of Quotation/Exchange

Total Value

Section 4: REAL ESTATE OWNED

Property A Property B Property C

Type of Property

Address

Date Purchased

Original Cost

Present Market Value

Name/Address of Mortgage Holder

Mortgage Account Number

Mortgage Balance

Payment Amount per Month

Section 5: OTHER PERSONAL PROPERTY AND OTHER ASSETS

(Describe, and if any is pledged as security, state name and address of lien holder, amount of lien, terms of payment, and delinquency, if applicable)

Section 6: UNPAID TAXES

(Describe in detail as to type, to whom payable, when due, amount, and to what property, if any, a tax lien attaches.)

Section 7: OTHER LIABILITIES (Describe in detail)

Section 8: LIFE INSURANCE HELD

(Give face amount and cash surrender value of policies, name of insurance company and beneficiaries)

I authorize Belco Community Credit Union to make inquiries as necessary to verify the accuracy of the statements made and to determine by creditworthiness. I certify that the above and the statements contained in the attachments are true and accurate as of the stated date(s). These statements are made for the purpose of either obtaining a loan or guaranteeing a loan. I understand that false statements may result in forfeiture of benefits and possible prosecution by the U.S. Attorney General (Reference 18 U.S.C. 1001).

Signature: Date: Social Security Number:

Signature: Date: Social Security Number:

References

Related documents

d/b/a Retirement Funding Solutions NMLS 1025894, Department of Financial Institutions - Arizona Mortgage Banker License 0926603; Licensed by the Department of Business Oversight

You may also get Disability Living Allowance or Personal Independence Payment (but not Attendance Allowance) if you have walking difficulties.. You may get support from Access to

The control store was used to identify seasonal and yearly sales changes, and from that give comparison data to the stores where the nudge was implemented.. 3.5.2 Time

This report shows George's and Marianne's income, taxes, expenses, including alimony income and child support income, including alimony expenses and child support expenses..

previously unavailable benchmarks for practical use, which are elaborated and discussed further in the Conservation Strategies section of the report.  Breeding plans and

Such a collegiate cul- ture, like honors cultures everywhere, is best achieved by open and trusting relationships of the students with each other and the instructor, discussions

The study dataset contained patient demographics, clinical outcomes, and cost data for patients treated in 12 Baylor Scott & White Health (BSWH) ICUs and was created by

The applicant shall be notified that in the event verification of eligibility should reveal the applicant does not fall within the requirements, the applicant shall be required to