Business Financing Application Form

Business Financing Application Form

The mandate of Muskoka Community Futures Development Corporation (Muskoka Futures) is to encourage economic growth and job creation throughout Muskoka by facilitating projects that strengthen the region’s economy and empower entrepreneurs to succeed through experienced guidance and financial investment in their ventures. Our mission is to facilitate and/or promote initiatives contributing to sustainable employment and economic growth by providing:

1. professionally guided access to business information, counseling, mentoring and financing to start up and expand business, and

2. facilitation services and/or funding initiatives for community economic development projects and activities servicing all our communities.

While the Muskoka Futures is a community-based venture, administered by a volunteer Board of Directors comprising a cross section of business people, it is a financing institution and the criteria for making investments is similar to those of conventional financial institutions. Our mandate is not to grant money, but, subject to Board approval, to invest in worthwhile and potential viable business ventures that will ultimately lead to job creation and/or the economic enhancement of our community.

Company Name: Prepared By: Date Prepared: Referred By:

(How did you hear about Muskoka Futures?)

Muskoka Futures 111 Manitoba Street Bracebridge, Ontario P1L 2B6 Phone: (705) 646-9511, 1-800-414-6570 Fax: (705) 646-9522 Email: [email protected] Web site: www.muskokafutures.ca

Muskoka Futures

Business Financing Application

1:0 Administrative Information

1:1 Business Information

Business Name: Address: Street: City:

Province: Postal Code:

Contact: Telephone: FAX:

E-mail:

1:2 Ownership/shareholder/management:

Please check: Proprietorship Partnership Corporation

Has business been registered? Yes Date: No

If not, please explain:

1:4 Principals’ Background

Provide a brief description of the background(s) of the principals, including work experience relevant to your application proposal: include resumes, if available.

1:5 Professional Advisors: (Name, Location, Phone #)

Solicitor: Accountant: Insurance Broker: Bank:

1:6 References:

Name: Address: City/Province: Postal Code: Telephone: Relationship: Name: Address: City/Province: Postal Code: Telephone: Relationship:

1:7 Other Obligations:

Is the applicant(s) or business an endorser, guarantor or consignor for obligations not listed on the financial statements?

Is the applicant(s) or business a party to any claim or lawsuit?

Yes No If so, please explain: Does the applicant(s) or business owe any back taxes (i.e. sales, income, realty or

business taxes)?

Yes No If so, please explain:

2:0 Proposal

The information as requested in sections 2:0 and 3:0 serves as an overview to your Business Proposal and usually provides sufficient information to permit an initial assessment of your application. Additional information or clarification of the data provided, including a comprehensive Business Plan, is generally required for the final approval process.

2:1 Describe the existing business and/or the proposed venture:

2:2 Identify your major competitors:

2:4 Describe major suppliers and the nature of your inventory:

2:5 Describe how you intend to market your business:

2:6 Describe how your background (education and work experience) relates to the proposed business:

2:7 Identify government regulations applicable to and licenses required to operate your proposed business:

Have you met these requirements?

2.8 Job Creation

Will your business or new proposal create new jobs in Muskoka? How many?

Present # of Employees, including principal(s): Full Time Part Time Number of jobs created, within one year: Full Time Part Time

2:9 Is business or cash flow seasonal?

Yes No When are the revenue periods high?

When are the revenue periods low?

Please explain:

3:0 Financing Information (Summary of Sources & Uses)

3:1 Project Costs by Category (Uses

)

3:3 Financial Statements:

please enclose the following:

 Existing Business: Financial Statements for the last 3 years  All Businesses: Opening Balance Sheet

Pro-forma Income and Expense Forecast (3 years) Pro-forma monthly Cash Flow Forecast (1 year)  Principal(s): Personal Financial Statement(s)

3:4 Investment Security:

List below the collateral you propose to offer towards the business financing. If applicable, indicate the fair market value of the assets. Examples of security would include assignment of receivables, inventory, business assets (including machinery and equipment), personal assets, property and loan guarantees.

Assets (indicate make, model, year, serial number, etc) Market Value Office Use Only

$ $

$ $

$ $

$ $

4:0 Declaration

The undersigned hereby declares that all of the information provided herein and on the accompanying statements is to the best of my/our knowledge true, complete and correct and I/we understand that it will be used by the Muskoka Community Futures

Development Corporation to determine credit worthiness. The proceeds of the

financing applied for will be used for business purposes and not for personal, family or household purposes.

The undersigned further consent(s) to Muskoka Community Futures Development Corporation making any inquiries it deems necessary to reach a decision on this

application, and consent(s) to the disclosure at any time to any credit information about me/us to any credit reporting agency or to any one with whom I/we have financial relations.

 Please check box to give expressed consent to receive our e-newsletter informing you about our services, upcoming workshops and other business topics of interest to you.

The Undersigned have authority to bind the Corporation:

Signature Title Date

Signature Title Date

Signature Title Date