business loan application - kitsap credit unionbusiness loan application page 2 of 7 rev. 11/2018...

BUSINESS LOAN APPLICATION CHECKLIST

To help make your business loan application process as smooth as possible, we’ve listed information below which is commonly required in the application process. Please note, additional information may be requested as your application package is reviewed.

Current personal financial statement; needed from all guarantors (form included with Business Loan Application)

Copies of completed signed personal tax returns for last three years (including all supporting schedules and K-1’s)

Copies of completed signed business tax returns for last three years (including all supporting schedules)

Signed 4506-T

Copies of year-end business Profit & Loss Statement and Balance Sheet for last three years

Copies of interim financial Statements (if beyond 6 months from FYE)

Business Information (as/if applicable)

Partnership Agreement

LLC or LLP Agreement

Copy of Business License

Rent Roll (if applicable)

Copy of leases including lists of in-progress or planned rental or lease rate increases (if not specified in the lease agreement)

Other:

Other:

Other:

Other:

Other:

If you have any questions about the application process, or the items required, please feel free to contact us.

BUSINESS LOAN APPLICATION

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IMPORTANT INFORMATION: Federal law requires all financial institutions to obtain, verify and record information that identifies each person and/or entity who opens an account. When you apply for an account, we will ask you for your name, street address, date of birth and other information that will allow us to identify you. We may also ask to see your driver’s license or other identifying documents.

SECTION 1: REQUEST INFORMATION PURPOSE

AMOUNT REQUESTED COLLATERAL OFFERED UNSECURED VEHICLE EQUIPMENT COMMERCIAL REAL ESTATE RESIDENTIAL REAL ESTATE SAVINGS ACCOUNT

SECTION 2: BUSINESS APPLICANT INFORMATION LEGAL NAME OF BUSINESS (Individual name for Sole Proprietor) BUSINESS TAX ID NUMBER

DBA NAME (If Applicable) DBA TAX ID NUMBER

STREET ADDRESS OF BUSINESS (No PO Boxes) CITY STATE ZIP

MAILING ADDRESS OF BUSINESS (If different than above) CITY STATE ZIP

BUSINESS PHONE NO. WEBSITE ADDRESS DATE ENTITY FORMED MM/DD/YYYY DATE OWNED SINCE MM/DD/YYYY

SECTION 3: TYPE OF ENTITY Corporation LLC General Partnership Trust S Corporation LLP Limited Partnership

SOLE PROPRIETOR APPLICANT ONLY APPLICANT & SPOUSE/REGISTERED DOMESTIC PARTNER

BUSINESS PRODUCT/SERVICE DESCRIPTION BUSINESS INDUSTRY RETAIL MANUFACTURER OTHER: PROFESSIONAL SERVICES WHOLESALER ________________________

BUSINESS ORGANIZED UNDER THE LAWS OF HOME BASED BUSINESS NUMBER OF EMPLOYEES YES NO

SECTION 4: CURRENT FINANCIAL INSTITUTION NAME OF INSTITUTION CHECKING BALANCE AS OF DATE SAVINGS BALANCE AS OF DATE

NAME OF INSTITUTION CHECKING BALANCE AS OF DATE SAVINGS BALANCE AS OF DATE

SECTION 5: DEBT SCHEDULE (Provide detail of total annual business payments) LENDER NAME

SECURED UNSECURED

LOAN LINE $______________ CURRENT BALANCE AS OF DATE MONTHLY PAYMENT MATURITY

LENDER NAME SECURED UNSECURED


LENDER NAME SECURED UNSECURED


Has business pledged inventory, accounts receivable, or equipment to secure existing debt? Yes No Is business a party to any claim or lawsuit? Yes No Has business ever declared Bankruptcy? Yes No Does business owe any past due taxes? Yes No Does business have a customer that accounts for 20% or more of total sales? Yes No Does business anticipate significant capital expenditures within the next twelve months? Yes No Does business have any pending loan applications at any other financial institution? Yes No


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SECTION 6: BUSINESS OWNERSHIP INFORMATION (Please complete this section for all owners and/or officers of the business. Attach additional pages if necessary) INDIVIDUAL NAME TITLE % OF BUSINESS OWNERSHIP

PHYSICAL HOME ADDRESS CITY STATE ZIP

IS SPOUSE/REGISTERED DOMESTIC PARTNER AN OWNER OR OFFICER OF BUSINESS? NO YES (If yes, complete section below)

SPOUSE/RDP NAME TITLE % OF BUSINESS OWNERSHIP

INDIVIDUAL NAME TITLE % OF BUSINESS OWNERSHIP












SECTION 7: CERTIFICATION OF BUSINESS APPLICANT Applicant certifies that the information provided on and with this form (including tax identification number) is complete and correct and that the undersigned are authorized to execute this form on behalf of the business applicant. The applicant authorizes Kitsap Credit Union (“Credit Union”) to obtain business credit reports, copies of tax returns and other such documentation and to take such steps as Credit Union deems appropriate to verify (and from time to time re-verify) the information provided with this form.

Applicant further agrees to execute and deliver to Credit Union such other forms, and take other action, as Credit Union requests in furtherance of the foregoing. The Credit Union will retain information received in relation to this credit request as long as the Credit Union deems necessary. Applicant authorizes Credit Union to release credit

information concerning same to other creditors, guarantors, credit bureaus, credit reporters, sureties, and to Credit Union’s agents and subsidiaries. Applicant agrees to promptly notify Credit Union in writing of any change in name, address or location of assets.

NAME DATE NAME DATE

AUTHORIZED SIGNATURE AUTHORIZED SIGNATURE

NAME DATE NAME DATE

AUTHORIZED SIGNATURE AUTHORIZED SIGNATURE


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SECTION 8: PERSONAL FINANCIAL INFORMATION (Complete for each owner. Attach additional sheets as necessary.) NOTE: Alimony, Child Support, or

Separate Maintenance Income need not be disclosed if you do not wish to have it considered as a basis for repayment of this obligation.

LAST NAME FIRST MIDDLE SOCIAL SECURITY NO

STREET ADDRESS (No PO Boxes) CITY STATE ZIP

MAILING ADDRESS (If different than above) CITY STATE ZIP

EMPLOYER POSITION NUMBER OF YEARS SALARY/WAGES

HOME PHONE WORK PHONE CELL PHONE DATE OF BIRTH

Are you relying on community property as a basis for repayment of the credit request? Yes No

Are you relying on your spouse’s/RDP’s income as a basis for repayment of the credit requested? Yes No Are you relying on the receipt of alimony, child support, or maintenance income as a basis for repayment of this credit request? Yes No If you answered yes to any of the above questions, please complete the sections below concerning your spouse/RDP

CO-APPLICANT (SPOUSE/RDP) LAST NAME

CO-APPLICANT (SPOUSE/RDP) FIRST

CO-APPLICANT (SPOUSE/RDP) MIDDLE

CO-APPLICANT (SPOUSE/RDP) SOCIAL SECURITY NO

CO-APPLICANT (SPOUSE/RDP) EMPLOYER

CO-APPLICANT (SPOUSE/RDP) POSITION

CO-APPLICANT (SPOUSE/RDP) NUMBER OF YEARS

CO-APPLICANT (SPOUSE/RDP) SALARY/WAGES

HOME PHONE WORK PHONE CELL PHONE DATE OF BIRTH

PERSONAL FINANCIAL STATEMENT

ASSETS (omit cents) LIABILITIES (omit cents)

Cash in Kitsap Credit Union Installment Obligations – Sch. H

Cash in Other Financial Institutions

Stocks/Bonds/Mutual Funds – Sch. A

Cash Value of Life Insurance – Sch. B

Credit Card debt

IRA – Sch. F

401K – Sch. G

Subtotal

Real Estate – Sch. C Real Estate Debt – Sch. C/D

Contracts and Mortgages Receivable – Sch. D or Rent Expense $ mo.

Accounts/Notes Receivable – Sch. E

Other Liabilities (Describe)

Closely Held Business Values

Income Tax Payable

Automobiles and Trucks

TOTAL LIABILITIES $

Other Assets (Describe) NET WORTH $

TOTAL ASSETS $ TOTAL LIABILITIES & NET WORTH $

Schedules A-I to be completed on the following pages 4-5 of this application.


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COMPLETE EACH SCHEDULE OR WRITE ‘NONE’ IN THOSE THAT DO NOT APPLY

Schedule A: Stocks / Bonds / Mutual Funds

Company Name/Symbol # of Shares Value per Share

Market Value Company Name/Symbol # of Shares

Value per Share

Market Value

$ $ $ $

$ $ $ $

$ $ $ $

$ $ $ $

$ $ $ $

$ $ $ $

$ $ $ $

$ $ $ $

$ $ $ $

TOTAL $

Schedule B: Life Insurance

Company Name Face Amount of Policy Cash Value In the Name of Beneficiary

$ $

$ $

$ $

$ $

Schedule C: Real Estate Unless otherwise noted, title to all real estate holdings is held in the name of

Property Address Type Current Value Monthly Income Mortgage Payable To Mortgage Balance Monthly

Payment Rate

Primary Residence $ $ $ $

$ $ $ $

Other:

$ $ $ $

$ $ $ $

$ $ $ $

$ $ $ $

TOTALS $ $ TOTALS $ $

Schedule D: Contracts and Mortgages Receivable

Name of Debtor Security and to Whom Receivable Balance Monthly Income Balance Owing Monthly Payment

$ $ $ $

$ $ $ $

TOTAL $ $ $ $

Schedule E: Accounts/Notes Receivable

Name Amount Due Date Name Amount Due Date

$ $

$ $


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Schedule F: IRA

Company Name/Symbol # of Shares

Value per Share Market Value Company Name/Symbol # of Shares

Value per Share Market Value

$ $ $ $

$ $ $ $

$ $ $ $

$ $ $ $

TOTAL $

Schedule G: 401K

Company Name/Symbol # of Shares

Value per Share Market Value Company Name/Symbol # of Shares

Value per Share Market Value

$ $ $ $

$ $ $ $

$ $ $ $

$ $ $ $

TOTAL $

Schedule H: Installment Obligations

Payable To Collateral Balance Monthly Payment

$ $

$ $

$ $

$ $

TOTAL $ $

Are you a guarantor or have contingent liabilities? Yes No

Schedule I: Contingent Liabilities/Guarantor Debt

Payable To On Behalf Of Maturity Date Collateral Monthly Payment

$

$

$

$

Estimated Taxable Income this Year Attorney’s Name

Taxable Income Prior Year Insurance Agent

Accountant’s Name Insurance Company

I (we) have provided information in this application truthfully. I (we) authorize Kitsap Credit Union to verify or check any of the information given, check credit references, verify employment, and obtain one more credit reports in connection with the credit application or in connection with any periodic review of any loans or credit which may be

extended to me (us). If I am married and live in a community property state, this authorization is also made on behalf of my spouse even if he or she is not a co-applicant.

I (we) give all of my (our) creditors permission to give Kitsap Credit Union any information it needs to make a credit granting decision. I (we) give Kitsap Credit Union permission to report to credit reporting agencies and others the results of such investigations and Credit Union’s experience with my (our) loan account.

NAME DATE NAME DATE

SIGNATURE SIGNATURE


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SECTION 9: Consent and Release

I, the undersigned, hereby give my permission, consent, and authorization to Kitsap Credit Union and its authorized employees to make any inquiries regarding the status of my personal and business credit, accounts, loans, and trade relationships, past, present and future, and employment, that the Credit Union deems reasonably required to process my request for a loan and to review future performance. This authorization includes, but is not limited to, credit bureau reports, direct contacts with financial institutions where I previously and/or presently have been granted credit, direct contacts with employers and landlords, and direct contacts with trade suppliers. I hereby authorize any of the above to release to the Credit Union information regarding any accounts, loans, contracts, and relationships. I also authorize release to the Credit Union, financial statements, tax returns, and other financial data from CPAs, accountants, and bookkeepers. I attest that tax returns, financial statements, or any other financial information provided in person or electronically now and in the future is truthfully represented. Additionally, I authorize release to the Credit Union, information from financial institutions, trusts, insurance companies, title companies, appraisers, attorneys, and consultants.

This signed form may be reproduced and a copy shall be as effective and binding as the original, which I have signed.

(If more than one signer, references to “I” and “my” are inclusive in the plural to “we” and “our”)

BUSINESS/ENTITY NAME

NAME DATE NAME DATE

SIGNATURE

NAME DATE NAME DATE

SIGNATURE

SECTION 10: Agreement to Reimburse for Third-Party Costs

The undersigned agrees to reimburse Kitsap Credit Union for all third party costs and expenses incurred as a direct result of this application. In the event this Application is cancelled by Applicant prior to closing, it is agreed that any required application deposit will first be credited towards third party costs and expenses with the balance retained by Kitsap Credit Union, at the Credit Union’s sole option.

BUSINESS/ENTITY NAME

NAME DATE NAME DATE

SIGNATURE

NAME DATE NAME DATE

SIGNATURE

SECTION 11: Disclosure of Right to Request Specific Reasons for Credit Denial

If your application for business credit is denied, you have the right to a written statement of the specific reasons for the denial. To obtain the statement, please contact Loan Servicing, PO Box 899, Silverdale WA 98383, within 60 days from the date you are notified of our decision. We will send you a written statement of reasons for the denial within 30 days of receiving your request for the statement.

Notice: The Federal Equal Credit Opportunity Act prohibits creditors from discrimination against credit applicants on the basis of race, color, religion, national origin, sex, marital status, age (provided that the applicant has the capacity to enter into a binding contract), because all or part of the applicant’s income is derived from any public assistance program, or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act. The federal agency that administers compliance with this law concerning the credit is:

Federal Trade Commission, Northwest Region 915 Second Avenue Room 2896 Seattle, WA 98174

Pursuant to the Equal Credit Opportunity Act, income from alimony, child support, or maintenance payment need not be revealed if you do not choose to disclose such income in our evaluation of your credit worthiness

business loan application - kitsap credit unionbusiness loan application page 2 of 7 rev. 11/2018...

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