BUSINESS LOAN APPLICATION PACKAGE

Transcription

1 BUSINESS LOAN APPLICATION PACKAGE 17 East Center, P.O. Box 32 * Lewiston, UT 84320: Phone: / North Main, P.O. Box 6097 * North Logan, UT 84341: Phone: South State Street, Suite B (Inside Stokes Market) * Preston, ID 83263: Phone: South Main * Logan, UT 84321: Phone: The following items are needed to process your application: ( ) Completed Business Loan Application ( ) Financial Statements (both personal & entity) ( ) Income Statements (both personal & entity) ( ) Most recent two years Tax Returns or W2 s (both personal & entity) ( ) Projected Cash Flow ( ) Entity documents and Tax ID No., copy of Drivers License ( ) Collateral Information (Description & Value) ( ) Other as needed:

2 BUSINESS LOAN APPLICATION Application Information Borrower/s or business Name: Applicant ( ) Corp. ( ) Prop ( ) Partn. ( ) Indiv ( ) LLC ( ) Trust Business Occupation: Tax ID or SS No: Address: Cell Phone: Business Phone: Application Information CoApplicant Borrower/s or business Name: Business Occupation: Tax ID or SS No: Address: Business Phone: Credit Request: Business Purpose ( ) New Loan/Line of Credit ( ) Renewal of Existing Loan/Line of Credit Amount Requested: Specific Purpose of Loan: Primary Source of funds to repay this loan: Secondary Source of funds to repay this loan: Collateral: Business Loan Application pg1

3 I hereby certify that all information in this document and any attachments are true and correct to the best of my knowledge. DATED: APPLICANT COAPPLICANT ( ) We intend to apply for joint credit: BOTH INITIAL IF JOINT CREDIT Applicant: CoApplicant: Business Loan Application pg2

4 ~..~ ~ ~~~~~ I LSB CONSUMER LOAN APPLICATION Creult ReqlJ(~stud IS: D Home E:.qulty Loan D Collateral Securud Loan D Persorldl Unsecured I_oan Account Requested: o Individual DJOlllt Amount Requested I Description ot C~llateral altered We Intend to apply tor joint credit Initial Purpose of Credit Request Applicant CoApplicant If the Applicant IS married, ile or she may apply for individual credll For Marital Status, check Olle if a) you are applying for a secured credit; b) you reside in a community property state; or c) you are relying on property in a community property state as a basis for repayment of the credit requested... t... Applicant APPLICANT INFORMATION Co Applicarit _._.. t Applicant Role: o Borrower D CoSigner o Guarantor Applicant Role: o Borrower D CoSigner D Guaralltor Applicant Name (include Jr. or Sr. If applicable) CoApplicant Name (irlelude Jr. or Sr. if applicable) I 1 j DaB I DaB Social Security Number Home Phone Ilnel_ area code) (rnmddyyyy) Social Security Number I Home Phone lincl_ area code) (rnmddyyyy) Address Address D Married IDependents (110t I,swd by Co Applicant) D Married IDepend.",ts Inot listed by Applleal1t) o Separated D ~lr~r;~::r~~ej:~~~u,d~ldowed) no. I ages D Separated D ~171~1::r~~~0(:~~~d~ldOWed) no. I ages Citizenship: D U.S. Citizen D Permanent Resldellt Allel) D Non Resident Allen Citizenship: D U.S. Citizen D Permanent ReSident AII(!rl D NonResident Allen Present Address (street, City, state, ZI P) since Present Address (street, City, state, ZIP) since Malllllg Address, if different from Present Address Maillllg Address, if different from Present Address If resldlllq at present address for less tllan two years complete the following' Fonner Address (street, city, state, ZIP) from to Former Address (street, City, state, ZIPI from to I Applicant EMPLOYMENT! INCOME INFORMATION Co AppUcant I Name & Address of Enlployer D Self Eillployed Yrs. on tills Job Name & Address of Employer D Selt Employed Yrs. on this job ~~~~ D Full tlflle D Full time Posltion;Title & Type at BUSiness I Boslness PllOne (incl area code) Position/Title & Type of BUSiness I Boslr1l!sS Phone IlrlCL area code} Gross Monthly Income Gross Monthly Income Name & Address of Employer o Self Employed Dale~ Name & Address of Employer D Self Employed Dates from from to... ~'~ PosltlonlTltle & Type ot BLlslness BUSiness Phone (Incl. area code) Posltlon.'Tltle & Type of Business I Business Phone IlrKI_ area code) I, Name & Address of Employer o Self Enlployed Dates Name & Address of Employer D S()lf Employed Dates to frolrl trom to Posltlon!Tltle & Type of Busilless I BUSiness Phone (inel area code) Position/Title & Type of Business I Business Pilone lincl area code) to NOTICE: Alimony, Child Support or Separate Maintenance Income need not be revealed it you do not wish to have it considered as a basis for repaying this obligation. Down D Rent since Flrlanclallnstitution Name I We hnreby appiy tor thu loan or credit de~crlbed In tills appllcarlor. I We cundy til3t I madu no I1lISrcpru.',E:ntatlorl~ Irl this loan application or In any related documents, that all information is true and complete ana that I we did 1101 omit any Importalll Ililorrl1ntlol1. I V'v'e agree tllilt (]f1y property securing trw 10al1 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 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 to any such insurer or investor any information and documentation that they may request with respect to my/our application, credit or loan. X"P ~ ~~~ ~~~_ x~~~~~ ~~~~~~ ~ ~_ Applicant Date CoApplicant Date

5 ASSETS AND LIABILITIES ADDENDUM TO CONSUMER LOAN APPLICATION L ~~ ~~~~~ Applicant: t1 Job Related Expense LASER PRO Lending. Var. 1:?.4.10.{)03 Copr. Harland Financial Solutions, Inc. 19~ All Rights R"scrved. L \CFI\LPL\COLALNAP.FC

6 Commercial Financial Statement Individuals Partnerships LLC Corporations Other Business Name & Address TIN Name of Owner/ Principal/Manager SSN Name of Owner/ Principal/Manager SSN Date of Birth Home Ph. Work Phone Date of Birth Home Ph. Work Phone Address Mailing Address Address Mailing Address CURRENT ASSETS Checking Accounts Notes Payable (Due in 1 Year) Savings Accounts Accounts Receivable Notes Receivable Inventory Total Current Assets INTERMEDIATE ASSETS Equipment & Machinery (See Schedule) Total Intermediate Assets ASSETS CURRENT LIABILITIES Accounts Payable Total Current Liabilities INTERMEDIATE LIABILITIES Total Intermediate Liablities LIABILITIES Notes Payable (Due in 15 Years)

7 ASSETS LIABILITIES LONGTERM ASSETS LONGTERM LIABILITIES Real Estate Real Estate Mortgages Long Term Notes Payable Buildings Total Fixed Assets TOTAL ASSETS Total Fixed Liabilities TOTAL LIABILITIES NET WORTH TOTAL LIABILITIES & NET WORTH Signature Date Signature Date

8 Notice of Right to Receive an Appraisal Lewiston State Bank may order an appraisal to determine any real property s value associated with this loan transaction and charge you for this appraisal. We will promptly give you a copy of any appraisal, even if your loan does not close. You can pay for an additional appraisal for your own use at your own cost.

9 ELECTRONIC DISCLOSURE DELIVERY AUTHORIZATION GENERAL AGREEMENT. For purposes of this Authorization the term Bank refers to the Bank named above. The terms you and your refer to the undersigned. The Electronic Signatures in Global and National Commerce Act, (ESign Act), Section 101(c)(1) of Title 1, allows a financial institution to issue electronic records to a customer to satisfy any statute or regulation that requires such information to be in writing, after first obtaining the customer s affirmative consent. The ESign Act requires certain information to be provided to the customer regarding this service, which is disclosed in this Authorization. You have the right to have the disclosures described in this Authorization provided or made available to you on paper. By signing the Electronic Disclosure Delivery Authorization you agree to the terms and conditions listed below. Please read this document carefully and retain it for future reference. ELECTRONIC DISCLOSURE DELIVERY. You hereby request and consent to the Bank sending your loan disclosures in Portable Document Format (PDF) to the address listed below. This Electronic Disclosure Delivery service replaces the creation of paper disclosure documents and their delivery through landbased mail services. Your consent applies to all disclosures related to any of your loan applications, accounts, and transactions with us, whether now existing or occurring in the future. In the event of equipment failure and you are unable to retrieve your s, you may obtain a copy of any disclosures on paper by telephoning Lewiston State Bank at or by sending a written request to: Lewiston State Bank, Attn: Loan Department. 17 E. Center St., Lewiston, Utah If you know your loan officer s name please send to his/her attention. No fee will be imposed to receive a paper copy of any disclosure delivered electronically. YOUR RESPONSIBILITIES. Equipment/Access requirements: In order to receive Electronic Disclosure Delivery, you must: Have an active account and access to a computer with access to the Internet Adobe Acrobat Reader 6.0 or higher (free software you can download) Participation in a onetime test to demonstrate your ability to receive with a PDF attachment and ability to open and view the content of the PDF Immediately notify us of any change in your address by sending a letter to Lewiston State Bank, Attn: Loan Department, 17 E. Center St., Lewiston, Utah If you know your loan officer s name send to his/her attention. You are solely responsible for the cost associated with receiving disclosures electronically (computer, Internet, services, etc.) WARRANT. You represent and warrant that you have the equipment and access capabilities to receive disclosures electronically. A onetime electronic verification will be conducted to ensure hardware/software capabilities. The hardware and software requirements may change at any time on thirty (30) days notice to you via . CANCELLATION. You may cancel this Authorization and request paper documents and disclosure delivery at any time by (A) providing thirty (30) days written notice by postal delivery addressed to: Lewiston State Bank, attn: Loan Department, 17 E. Center St., Lewiston, Utah If you know your loan officer s name send to his/her attention. or by (B) visiting a Lewiston State Bank loan office in person. Lewiston State Bank will not impose any fees for cancellation. Cancellation is effective thirty (30) days after Bank's receipt of your written notice of cancellation by postal delivery or thirty (30) days if done in person. OTHER CANCELLATION RIGHTS. Lewiston State Bank may also cancel this Authorization and opt to deliver disclosures by paper at its sole discretion. Applicant: Printed Name: Signature: Coapplicant: Printed Name: Signature: Date: Address: Date: Address: V201305LEND Mnder.

10

11