Loan Application Thank you for choosing our on-line submission option. Please be advised that all information submitted is considered confidential. This preliminary application will get us started with the loan process. Contact Information Contact Name: Company Name: Email Address: Address: City: State: Please Select Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip: Home Phone:         Work Phone:         Cell Phone:         Fax Number:         Website URL: Best Way to Contact Me: Please Select Business Phone Cell Phone Email Fax Home Phone   Best time to call:   Morning Afternoon I am interested in a loan to: Please Select Acquire Established Business Buy Franchise Expand Current Business Start-Up My Own Opportunity         Estimated Loan Amount: Please Select Less than $100,000 $100,000 - $150,000 $150,000 - $300,000 $300,000 - $500,000 $500,000 - $1,000,000 Over $1,000,000         Your Timetable: Please Select Within 60 Days 2-6 Months 6 Months or More Exploring Options         Type of Business: Please Select Automotive Computer/Hi-Tech Food Service Gas/Convenience Health Industry Hotel/Motel Manufacturing Retail Store Service Industry Transportation Other                     Additional Information The following information is optional, but can be very important to help us evaluate whether you will qualify for an SBA or other types of loans. Please fill out what you can. Have you applied for a  business loan within the last year? Yes No If yes, describe:     Have you or any principal (partner) ever had a bankruptcy? Yes No If yes, how many years ago? Describe:     Are you or any principal (partner) involved in any pending lawsuits? Yes No If yes, describe:     Are all your current taxes paid? Yes No Do you owe money on student loans? Yes No If yes, are you current with your payments? Yes No Do you have the ability to make a down payment on the loan? Yes No If yes, how much can you put down: Do you own your own home? Yes No If yes, how long have you lived there? How much equity do you have in your house? Describe any other collateral that you can offer if it is needed:     Will there be partners?     Yes No Don't Know       If you are married, will your spouse be on the loan? Yes No Don't Know       If yes, describe: Are you and your partners US Citizens? Yes No Not All       If no, do you or your partners/spouse have a "green card"? Yes No Not All       Comments: Have you ever been arrested or convicted for a criminal offense? Yes No If yes, when did this occur and describe the circumstances and nature of arrest and/or conviction: If you are opening a franchise business, have you been approved by the franchise? Yes No Application Pending       If it is a start-up or first time business acquisition, do you have direct or related experience in the business.  Describe work and/or management experience or skills that will enable you to run the new business: Other comments: