Business Loan Application 1st State Bank

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Business Loan Application

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Business Loan Application

Application for business loans

Name(Required)

First Last

1. Loan Request

Business must be located in Saginaw, Bay, or Midland County. Maximum Aggregate Credit Exposure $250,000. (Customers with existing loans at 1st State Bank please contact your Business Lender)

Loan Type(Required)

Line of Credit ($150,000 max)

Equipment Loan ($250,000 max)

Real Estate Loan ($250,000 max)

Other ($250,000 max)

Line of Credit Request Amount(Required)

Equipment Loan Request Amount(Required)

Real Estate Loan Request Amount(Required)

Other Loan Request Amount(Required)

Description/Purpose of Loan Request(Required)

Available Collateral

Accounts Receivable

Inventory

Equipment

Vehicle

Real Estate

Other (explain)

Explain "Other" Here

Accounts Receivable Collateral Value

Inventory Collateral Value

Equipment Collateral Value

Vehicle Collateral Value

Real Estate Collateral Value

Other Collateral Value

2. Business Information

Business Classification(Required)

Sole Proprietorship

S-Corporation

C-Corporation

Partnership

Limited Liability (LLC/LLP)

Professional Corporation (PC/PLC)

Individual (Business)

Non-Profit

Business Name(Required)

Tax/Employee Identification Number(Required)

Confirm Tax/Employee Identification Number(Required)

Company Address(Required)

Street Address Address Line 2 City State ZIP Code

Business Phone(Required)

Business Contact Name(Required)

Business Contact Email(Required)

Today's Date(Required)

MM slash DD slash YYYY

Date Business Established(Required)

MM slash DD slash YYYY

Present Management/Ownership Since(Required)

MM slash DD slash YYYY

Recent Year-End Gross Revenue(Required)

Recent Year-End Net Profit (Loss)(Required)

3. Owners/Guarantors

List any Individual who has 20% or more ownership or would be a guarantor of the loan.

Owner/Guarantor #1

Name(Required)

First Last

Title(Required)

Ownership Percentage(Required)

SSN#/TIN#(Required)

Date of Birth(Required)

MM slash DD slash YYYY

Phone(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Owner/Guarantor #2

Name

First Last

Title

Ownership Percentage

SSN#/TIN#

Date of Birth

MM slash DD slash YYYY

Phone

Address

Street Address Address Line 2 City State ZIP Code

Owner/Guarantor #3

Name

First Last

Title

Ownership Percentage

SSN#/TIN#

Date of Birth

MM slash DD slash YYYY

Phone

Address

Street Address Address Line 2 City State ZIP Code

Owner/Guarantor #4

Name

First Last

Title

Ownership Percentage

SSN#/TIN#

Date of Birth

MM slash DD slash YYYY

Phone

Address

Street Address Address Line 2 City State ZIP Code

4. Additional Information

Has the business incurred any loss in the last three years?

Yes

No

Is the business, owners, or guarantors party to any claim, judgement, or lawsuit?

Yes

No

Has the business, owners, or guarantors been involved in any bankruptcy proceedings?

Yes

No

Are more than 20% of revenues from, or expenses to, any related entity?

Yes

No

Is the business or any of its assets for sale or under agreement for sale?

Yes

No

5. Signatures

Company Legal Name

Company Representative Consent(Required)

I agree to the certifications below.

A. If multiple applicants/guarantors are joining in on this application, the undersigned intend to apply jointly as Borrowers and/or Guarantors of the loans for the company listed on the application, if applicable. The assets and income of each Borrower and Guarantor will be relied upon as a basis for the loan request.

B. each undersigned (1) certifies that all information furnished and to be furnished in connection with this application is and will be true and complete, without omission of information, and fairly represents the financial condition of the Borrowers and/or Guarantors; and (2) grants connection with the application, Including but not limited to business and personal credit reports.

C. The federal Equal Credit Opportunity Act prohibits creditors from discriminating agains credit applicants on the basis of race, color, religion, national origin, sex, marital status, age (provided the applicant has the capacity to enter into a binding contract); because all or party of the applicant's income derives from any public assistance program; or because the applicant has a good faith exercised any right under the Consumer Credit Protection Act. The Federal Agency that administers compliance with this law concerning this creditor is FDIC Consumer Response Center, 1100 Walnut Street, Box #11, Kansas City, MO 64106.

Company Representative Title(Required)

Owner/Guarantor #1 - Name(Required)

First Last

Owner/Guarantor #1 - Consent(Required)

I agree to the certifications below.

A. If multiple applicants/guarantors are joining in on this application, the undersigned intend to apply jointly as Borrowers and/or Guarantors of the loans for the company listed on the application, if applicable. The assets and income of each Borrower and Guarantor will be relied upon as a basis for the loan request.

B. each undersigned (1) certifies that all information furnished and to be furnished in connection with this application is and will be true and complete, without omission of information, and fairly represents the financial condition of the Borrowers and/or Guarantors; and (2) grants connection with the application, Including but not limited to business and personal credit reports.

C. The federal Equal Credit Opportunity Act prohibits creditors from discriminating agains credit applicants on the basis of race, color, religion, national origin, sex, marital status, age (provided the applicant has the capacity to enter into a binding contract); because all or party of the applicant's income derives from any public assistance program; or because the applicant has a good faith exercised any right under the Consumer Credit Protection Act. The Federal Agency that administers compliance with this law concerning this creditor is FDIC Consumer Response Center, 1100 Walnut Street, Box #11, Kansas City, MO 64106.

Owner/Guarantor #2 - Name

First Last

Owner/Guarantor #2 - Consent

I agree to the certifications below.

A. If multiple applicants/guarantors are joining in on this application, the undersigned intend to apply jointly as Borrowers and/or Guarantors of the loans for the company listed on the application, if applicable. The assets and income of each Borrower and Guarantor will be relied upon as a basis for the loan request.

B. each undersigned (1) certifies that all information furnished and to be furnished in connection with this application is and will be true and complete, without omission of information, and fairly represents the financial condition of the Borrowers and/or Guarantors; and (2) grants connection with the application, Including but not limited to business and personal credit reports.

C. The federal Equal Credit Opportunity Act prohibits creditors from discriminating agains credit applicants on the basis of race, color, religion, national origin, sex, marital status, age (provided the applicant has the capacity to enter into a binding contract); because all or party of the applicant's income derives from any public assistance program; or because the applicant has a good faith exercised any right under the Consumer Credit Protection Act. The Federal Agency that administers compliance with this law concerning this creditor is FDIC Consumer Response Center, 1100 Walnut Street, Box #11, Kansas City, MO 64106.

Owner/Guarantor #3 - Name

First Last

Owner/Guarantor #3 - Consent

I agree to the certifications below.

A. If multiple applicants/guarantors are joining in on this application, the undersigned intend to apply jointly as Borrowers and/or Guarantors of the loans for the company listed on the application, if applicable. The assets and income of each Borrower and Guarantor will be relied upon as a basis for the loan request.

B. each undersigned (1) certifies that all information furnished and to be furnished in connection with this application is and will be true and complete, without omission of information, and fairly represents the financial condition of the Borrowers and/or Guarantors; and (2) grants connection with the application, Including but not limited to business and personal credit reports.

C. The federal Equal Credit Opportunity Act prohibits creditors from discriminating agains credit applicants on the basis of race, color, religion, national origin, sex, marital status, age (provided the applicant has the capacity to enter into a binding contract); because all or party of the applicant's income derives from any public assistance program; or because the applicant has a good faith exercised any right under the Consumer Credit Protection Act. The Federal Agency that administers compliance with this law concerning this creditor is FDIC Consumer Response Center, 1100 Walnut Street, Box #11, Kansas City, MO 64106.

Owner/Guarantor #4 - Name

First Last

Owner/Guarantor #4 - Consent

I agree to the certifications below.

A. If multiple applicants/guarantors are joining in on this application, the undersigned intend to apply jointly as Borrowers and/or Guarantors of the loans for the company listed on the application, if applicable. The assets and income of each Borrower and Guarantor will be relied upon as a basis for the loan request.

B. each undersigned (1) certifies that all information furnished and to be furnished in connection with this application is and will be true and complete, without omission of information, and fairly represents the financial condition of the Borrowers and/or Guarantors; and (2) grants connection with the application, Including but not limited to business and personal credit reports.

C. The federal Equal Credit Opportunity Act prohibits creditors from discriminating agains credit applicants on the basis of race, color, religion, national origin, sex, marital status, age (provided the applicant has the capacity to enter into a binding contract); because all or party of the applicant's income derives from any public assistance program; or because the applicant has a good faith exercised any right under the Consumer Credit Protection Act. The Federal Agency that administers compliance with this law concerning this creditor is FDIC Consumer Response Center, 1100 Walnut Street, Box #11, Kansas City, MO 64106.

Upon receipt of your application, you will be contacted by a 1st State Bank Business Lender within one business day.

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