ValueBank Texas Commercial Loan Application

ValueBank Texas Commercial Loan Application Business Information: Business Name Full Street Address City County State Zip Primary Contact Phone ( ) Fax ( ) Secondary Contact Phone ( ) Fax ( ) Type of Business Type of Entity: Corporation Partnership LLC Sole Proprietorship Other Date Business established / / Tax I.D. Business e-mail address Business Ownership: (Attach additional pages if necessary) Name Title % of Ownership Name Title % of Ownership Name Title % of Ownership Affiliate Businesses, if applicable: (Attach additional pages if necessary) Name Address Type of Business Tax I.D. Existing Business Locations: (Attach additional pages if necessary) Address City State Zip Rent Own Square Feet Monthly Payment Address City State Zip Rent Own Square Feet Monthly Payment References: (Attach additional pages if necessary) Bank of Business Account Acct. Officer Phone Accountant Name Phone Attorney Name Phone 1

Insurance Agent Name Phone Does your company maintain key person life insurance on any owner or officer? Yes No Life Insurance Agent Phone Name of Insured Amount $ Life Insurance Company Beneficiary Trade References: (Attach additional pages if necessary) Contact Person Phone Contact Person Phone Employee Information: Number of current employees : Estimated number of new employees within next two years as a result of this loan. Number of current employees at affiliated businesses (if applicable) Key Employees: (Attach additional pages if necessary) Name Title Responsibilities Years with Company Years in Industry Additional Information (Please answer the following questions and provide additional information where necessary): Have you or any officer of your company ever been involved in bankruptcy or insolvency proceedings? Yes No (If yes, please provide details) Are you or your business / affiliate involved in any pending lawsuits? Yes No (If yes, please provide details) Does the business owe any taxes for years prior to the current year? Yes No (If yes, please provide details) Is the business an endorser, guarantor, or co-maker for obligations not listed on its financial statements? Yes No (If yes, please provide details) Does your business use or store any hazardous / toxic materials or produce hazardous / toxic materials? Yes No (If yes, please provide details) Do you or your spouse or any member of your household, or anyone who owns, manages, or directs your business or their spouses or members of their households work for the Small Business Administration, Small Business Advisory Council, SCORE or ACE, any Federal Agency, or the participating lender? Yes No (If yes, please provide details) Does your business, its owners or majority stockholders own or have a controlling interest in other businesses? Yes No (If yes, please provide details, including their names, relationship with your company, and ownership) Do you buy from, sell to, or use the services of any concern in which someone in your company has a significant financial interest? Yes No (If yes, please provide details, including their names, relationship with your company, and ownership) Does your business currently export, or will it start exporting, pursuant to this loan (if approved)? Yes No If Yes, what is your estimate of the total annual export sales this loan would support $ Would you like information on exporting? Yes No 2

Previous Government Financing, Loans (incl. Student Loans), Debts, and/or Other Obligations: (Attach additional pages if necessary) If you or any principals or affiliates have ever requested Government Financing complete the following: Name of Entity Original Amount of Loan Date of Request Approved or Declined Balance Current or Past Due Assistance with preparing this Information: (Attach additional pages if necessary) List the name(s) and occupations of anyone who you paid or agreed to pay to assist with the preparation of this application: Name and Occupation Address Total Fees Paid Fees Due Description of Your Business: (Please attach additional page(s) as needed or substitute with your business plan) History of your business: Types of products and/or services (attach any catalogs, brochures, etc.): History of the business: Industry outlook: How will this loan benefit your business? Geographic market area where business operates: List key customers: List key competitors: Future Plans: 3

Project Information: (Attach additional pages if necessary) Project Description (Explain what you want to do; attach additional pages, if necessary): Street Address of Project City State Zip County Total Project Costs and Uses of Funds: Collateral Offered: If Mortgaged, Present Market Value Present Loan Balance Real Estate Acquisition $ Land (vacant) $ $ New Construction/Expansion/Repair $ Land & Buildings $ $ Acquisition of Machinery and Equipment $ Machinery/Equip. $ $ Acquisition of Existing Business $ Furniture $ $ Inventory Purchase $ Leasehold Impr. $ $ Working Capital $ Accounts Rec. $ $ Payoff Bank Loan (Copy of notes required) $ Inventory $ $ Other Debt Payment (Details attached) $ Other $ $ All Other $ Other $ $ All Other $ Other $ $ Total Project Costs $ Total $ $ Less: Borrower s Injection / Down Payment $ Loan Amount $ ; and, Repayment Terms in Years - or - monthly payment amount preferred/requested. Source of Applicant s, Injection, and/or Down Payment If purchasing real property, how will the property be owned? (i.e. individually, partnership, corporation, trust, etc.) (Please provide appropriate documentation (i.e. Sales/Purchase Contract, Partnership Agreement, Articles of Incorporation, Trust Agreement, etc.) Please attach copies of bids, purchase orders, invoices, estimates, cost budgets, contracts, etc. for the total project costs above. I / We certify that the above information and information contained in attachments / exhibits is true and accurate to the best of my / our knowledge. Name of Applicant (s) Authorized Signature Date Name of Applicant (s) Authorized Signature Date 4

P. O. Box 4956 Corpus Christi, Texas 78469 361-888-4451 AUTHORIZATION TO INVESTIGATE CHARACTER & CREDIT HISTORY The information contained in this statement, including any supplements, is provided to induce ValueBank Texas, its affiliate(s), agent(s), associate(s), participant(s), or other lender(s), collaborator(s), or colleague(s) (hereinafter referred to as VBT) to extend, or consider extending, or continue the extension of credit to the undersigned or to others upon the guarantee of the undersigned. The undersigned acknowledge and understand that VBT is relying on the information provided herein and herewith in deciding to grant or continue credit or to accept a guarantee thereof. Each of the undersigned represents, warrants, and certifies that the information provided herein and herewith is true, correct, and complete. Each of the undersigned agrees to notify VBT immediately and in writing of any change in the information and of any material adverse change in the financial condition or the ability to perform obligations of the undersigned. In the absence of such notice or a new and full written statement, this should be considered as a continuing statement and substantially correct. VBT or its agents are authorized to make all inquiries VBT deems necessary to verify the accuracy of the information contained herein and herewith and to determine the creditworthiness of the undersigned. The undersigned agree to reimburse VBT for any and all expenses incurred in the consideration, making, and/or administration of any and all loans or other extensions of credit related hereto. The undersigned authorize any consumer, commercial, or credit reporting agency, creditor, employer, reference, or any other person or entity to give VBT, its agents, associates, etc., any information it may have on the undersigned. The undersigned further authorizes VBT, its agents, associates, etc., to share all information. This statement and any other information that the undersigned furnish to VBT or that VBT obtains hereinafter related shall be VBT property whether credit is extended or not. FULL NAME: ADDRESS: CITY: STATE: ZIP: SOCIAL SECURITY # DATE OF BIRTH: SIGNATURE: DATE: PHONE # : PLEASE COMPLETE FOR JOINT REQUESTS: FULL NAME: ADDRESS: CITY: STATE: ZIP: SOCIAL SECURITY # DATE OF BIRTH: SIGNATURE: DATE: PHONE # : 5

Customer/Applicant Identification Form Applicant Name Address (Physical Address, or directions if above is a P.O. Box #) City, State, Zip Code Email Address Date of Birth Social Security # or TIN # ID# ID Issue Date SSN Issue Date ID Issuer (State) ID Expiration Date Verified by: Initials 6

Customer/Applicant Identification Form Co-Applicant Name Address (Physical Address, or directions if above is a P.O. Box #) City, State, Zip Code Email Address Date of Birth Social Security # or TIN # ID# ID Issue Date SSN Issue Date ID Issuer (State) ID Expiration Date Verified by: Initials 7

Commercial Credit Denial Notice Commercial Credit Denial Notice To The Commercial Applicant: If your gross revenues were 1,000,000.00 or less in your previous fiscal year, or you are requesting trade credit, a factoring agreement, or similar types of business credit in the Commercial Loan Application, and if you 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... VALUEBANK TEXAS 3649 LEOPARD STREET CORPUS CHRISTI, TX 78408 within 60 days from the date you are notified of our decision. We will send you a written statement of reason for the denial within 30 days of receiving your request for the statement. The notice that follows describes additional protections extended to you. EQUAL CREDIT OPPORTUNITY NOTICE: The federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national origin, sex, martial status, age (providing the applicant has the capacity to enter into a binding contract), because all or part of the applicant s income derives from any public assistance program, or because applicant has in good faith exercised any right under the Consumer Credit Protection Act. The federal agency that administers compliance with this law concerning this creditor is: FEDERAL DEPOSIT INSURANCE COMPANY 1100 WALNUT STREET, SUITE 2100 KANSAS CITY, MO 64106 1(800)209-7459 8

Other Important Information Other Important Information ValueBank Texas is chartered under the laws of the State of Texas and by state law is subject to regulatory oversight by the Texas Department of Banking. Any consumer wishing to file a complaint against ValueBank Texas should contact the Texas Department of Banking. ValueBank Texas also engages in the money transmission and currency exchange business as an authorized delegate of American Express. MoneyGram and Currency Exchange International under Chapter 151 of the Texas Finance Code. If you have a complaint, first contact the consumer assistance division of MoneyGram at (800)-549-3590 or Currency Exchange International at, (888)-998-3948 if you still have an unresolved complaint regarding the company s money transmission or currency exchange activity, please direct your complaint to Texas Department of Banking. Consumers/customers may file complaints with the Texas Department of Banking by contacting the Department through one of the means indicated below: In Person or U.S. Mail to... Telephone Number... Fax Number... E-Mail Address... Website... Texas Department of Banking Attention: Consumer Assistnance Activities 2601 North Lamar Boulevard (877)276-5554 (toll free) (512)475-1313 consumer.complaints@dob.texas.gov www.dob.texas.gov Thank you very much for banking with ValueBank Texas. We are proud to have you as a customer and you may rest assured that we are doing everything possible to protect the privacy of the financial information you have entrusted us with. 9

Privacy Disclosure Questions? Call (361)888-4451 or go to valuebanktexas.com FACTS WHAT DOES VALUEBANK TEXAS DO WITH YOUR PERSONAL INFORMATION Why? Financial companies choose how they share your personal information. Federal law gives consumers the right to limit some but not all sharing. Federal law also requires us to tell you how we collect, share and protect your personal information. Please read this notice carefully to understand what we do. What? The types of personal information we collect and share depends on the product or service you have with us. This information can include: Social Security Number and Income Account Balances and Payment History Credit History and Credit Scores How? When you are no longer our customer, we continue to share your information as described in this notice. All financial companies need to share customers personal information to run their everyday business. In the section below, we list the reason financial companies can share their customer s personal information: the reasons ValueBank Texas chooses to share; and whether you can limit this sharing. Reasons we can share your personal information For our everyday business purposes - such as to process your transactions, maintain your account(s), respond to court orders and legal investigations Does ValueBank Texas share? Can you limit this sharing? Yes No Four our marketing purposes - to offer our products and services to you Yes No For joint marketing with other financial companies No We Do Not share For our affiliates everday business purposes - information about your transactions and experiences No We Do Not share For our affiliates everyday business purposes - information about your credit worthiness No We Do Not share For our affiliates to market to you No We Do Not share For non-affiliates to market to you No We Do Not share Who We Are Who is providing this notice? ValueBank Texas What We Do How does ValueBank Texas protect my personal information? To protect your personal information from unauthorized access and use, we use security measures that comply with federal law. These measures include computer safeguards and secured files and buildings. How does ValueBank Texas collect my personal information? We collect your personal information, for example, when you Open an account Pay your bills or apply for a loan Use your debit or credit card Why can t I limit all sharing? Federal law gives you the right to limit only Sharing for affiliates everyday business purposes - information about your credit worthiness Affiliates from using your information to market to you Sharing for non-affiliates to market to you State laws and individual companies may give you additional rights to limit sharing Definitions Affiliates Companies related by common ownership or control. They can be financial or non-financial companies Non-Affiliates Companies not related by common ownership or control. They can be financial or non-financial companies Joint Marketing A formal agreement between non-affiliated financial companies that together market financial products or services to you 10

Additional Needed Documentation, Checklist: Business Information: (Please supply the following information, as applicable) (All information should be signed & dated) Business Tax Returns for the past three years. Interim Financial Statements (P&L and Balance Sheet) within 45 days of application (form attached). Listing & Aging of Accounts Receivable and Accounts Payable dated the same date as the interim financial statements. Business Debt Schedule dated the same date as the interim financial statements (form attached). Projections of Income & Expenses for next 3 years, if loan approved, with supporting assumptions (forms attached). Legal Entity Documents: Articles of Incorporation, Certificate of Incorporation, and By-laws for corporations. Articles of Organization, Articles of Formation, and Operating Agreement for LLCs. Partnership Agreement for partnerships. Copies of Assumed Name Certificate(s) and Business License(s). Franchise Agreement and FTC Disclosure Document for licensed franchises. Copy of existing or new leases to be entered. Affiliate Business Information: Business Tax Returns for the past three years (signed and dated). Interim Financial Statements (P&L and Balance Sheet) within 45 days of application (form attached). Business Debt Schedule dated the same as the interim financial statement (form attached). Legal Entity Documents: Articles of Incorporation, Certificate of Incorporation, and By-laws for corporations. Articles of Organization and Operating Agreement for LLCs. Partnership Agreement for partnerships. Assumed Name Certificate and Business License. Franchise Agreement and FTC Disclosure Document (if applicable). Personal Information: (for each owner) Personal Tax Returns for the past three years. Personal Resume for each owner / shareholder / guarantor. (form(s) attached). Personal Financial Statement for each owner / shareholder / guarantor. (form(s) attached). Collateral Information: Real estate Sale/Purchase Agreement, Title Company Settlement Statement, and/or Deed. Asset purchase agreement & copy of bill of sale for business acquisition. Construction cost-budget and/or bids. Equipment cost-budget and/or bids. Existing environmental studies, appraisals, and surveys on the property. 11

PERSONAL RESUME/INFORMATION (Please complete for each owner of the business) Name First Middle Initial Last Social Security No. Home Phone Business Phone Cell Phone Address City State Zip Immediate past address City State Zip From / To / e-mail address Driver s License / Passport # Issuer (State or Country) Issue Date Exp. Date Verified Initials For Bank Use Only Spouse s name* First Middle Initial Last *You are not required to provide information regarding a spouse unless the spouse is a co-applicant for the loan, you are relying on the spouse s income for repayment of the loan, you reside in a community property state, the proposed business is located in such a state, or you are relying on alimony, child support, or separate maintenance as a source of repayment. EDUCATION: (High School, College or Technical Training) Name and Location Dates Attended Major Degree / Certificate WORK EXPERIENCE: (List chronologically beginning with present employment) Name of company Address City State Zip From / To / Title Job Description Name of company Address City State Zip From / To / Title Job Description Name of company Address City State Zip From / To / Title Job Description 12

PERSONAL FINANCIAL STATEMENT As of, Complete this form for: (1) each proprietor, or (2) each limited partner who owns 20% or more interest and each general partner, or (3) each stockholder owning 20% or more of voting stock, or (4) any person or entity providing a guaranty on the loan. Name Business Phone Residence Address Residence Phone City, State, & Zip Code Business Name of Applicant/Borrower ASSETS Cash on hand & in Banks Savings Accounts IRA or Other Retirement Account Accounts & Notes Receivable Life Insurance-Cash Surrender Value Only (Complete Section 8) Stocks and Bonds (Describe in Section 3) Real Estate (Describe in Section 4) Automobile-Present Value Other Personal Property (Describe in Section 5) Other Assets (Describe in Section 5) Section 1. Source of Income Salary Net Investment Income Real Estate Income Other Income (Describe below)* Total (Omit Cents) LIABILITIES (Omit Cents) $ Accounts Payable $ $ Notes Payable to Banks and Others $ $ (Describe in Section 2) $ Installment Account (Auto) $ $ Mo. Payments $ Installment Account (Other) $ $ Mo. Payments $ Loan on Life Insurance $ $ Mortgages on Real Estate $ (Describe in Section 4) $ Unpaid Taxes $ $ (Describe in Section 6) Other Liabilities $ $ (Describe in Section 7) Total Liabilities $ Net Worth $ $ Total $ Contingent Liabilities $ As Endorser or Co-Maker $ $ Legal Claims & Judgments $ $ Provision for Federal Income Tax $ $ Other Special Debt $ Description of Other Income in Section 1. *Alimony or child support payments need not be disclosed in "Other Income" unless it is desired to have such payments counted toward total income. Section 2. Notes Payable to Banks and Others. (Use attachments if necessary. Each attachment must be identified as a part of this statement and signed.) Original Current Payment Frequency How Secured or Endorsed Name and Address of Noteholder(s) Balance Balance Amount (monthly,etc.) Type of Collateral 13

Section 3. Stocks and Bonds. (Use attachments if necessary. Each attachment must be identified as a part of this statement and signed). Number of Shares Name of Securities Cost Market Value Date of Total Value Quotation/Exchange Quotation/Exchange Section 4. Real Estate Owned. Type of Property (List each parcel separately. Use attachment if necessary. Each attachment must be identified as a part of this statement and signed.) Property A Property B Property C Address Date Purchased Original Cost Present Market Value Name & Address of Mortgage Holder Mortgage Account Number Mortgage Balance Amount of Payment per Month/Year Status of Mortgage Section 5. Other Personal Property and Other Assets. (Describe, and if any is pledged as security, state name and address of lien holder, amount of lien, terms of payment and if delinquent, describe delinquency) Section 6. Unpaid Taxes. (Describe in detail, as to type, to whom payable, when due, amount, and to what property, if any, a tax lien attaches.) Section 7. Other Liabilities. (Describe in detail.) Section 8. Life Insurance Held. (Give face amount and cash surrender value of policies - name of insurance company and beneficiaries) I authorize SBA/Lender to make inquiries as necessary to verify the accuracy of the statements made and to determine my creditworthiness. I certify the above and the statements contained in the attachments are true and accurate as of the stated date(s). These statements are made for the purpose of either obtaining a loan or guaranteeing a loan. I understand FALSE statements may result in forfeiture of benefits and possible prosecution by the U.S. Attorney General (Reference 18 U.S.C. 1001). Signature: Date: Social Security Number: Signature: Date: Social Security Number: 14

Cash Flow Statement STATEMENT DATE $ $ $ CASH FLOW FOR PERSONAL FINANCIAL STATEMENT INCOME Monthly Year Projected Next Yr. Salary/Wages Bonus/Commissions Dividends/Interest Trust Income Rentals/R.E. Income (net exp.) Royalties Capital Gains Equipment Leases Gifts/Inheritances Legal/Insurance Settlements Tax Refund Spouse Income Other TOTAL INFLOWS $ - $ - $ - EXPENSES Housing (Mortgage or Rent) Auto Payment Other Loan Payments Credit Card Payments Insurance Payments (Car, Home, Life, Health) Property Taxes (if not included in mortgage) Electric/Gas Bill/Water Phone Bill Gasoline Groceries Child Support Child Care Other Living Expenses TOTAL OUTFLOWS (Expenses) NET CASH FLOW (Income - Expenses) $ $ - - $ $ - - $ $ - - 15

The information contained in this statement, including any supplements, is provided to induce ValueBank Texas, its affiliate(s), agent(s), associate(s), participant(s), or other lender(s), collaborator(s), or colleague(s) (hereinafter referred to as VBT) to extend, or consider extending, or continue the extension of credit to the undersigned or to others upon the guarantee of the undersigned. The undersigned acknowledge and understand that VBT is relying on the information provided herein and herewith in deciding to grant or continue credit or to accept a guarantee thereof. Each of the undersigned represents, warrants, and certifies that the information provided herein and herewith is true, correct, and complete. Each of the undersigned agrees to notify VBT immediately and in writing of any change in the information and of any material adverse change in the financial condition or the ability to perform obligations of the undersigned. In the absence of such notice or a new and full written statement, this should be considered as a continuing statement and substantially correct. VBT or its agents are authorized to make all inquiries VBT deems necessary to verify the accuracy of the information contained herein and herewith and to determine the creditworthiness of the undersigned. The undersigned agree to reimburse VBT for any and all expenses incurred in the consideration, making, and/ or administration of any and all loans or other extensions of credit related hereto. The undersigned authorize any consumer, commercial, or credit reporting agency, creditor, employer, reference, or any other person or entity to give VBT, its agents, associates, etc., any information it may have on the undersigned. The undersigned further authorizes VBT, its agents, associates, etc., to share all information. This statement and any other information that the undersigned furnish to VBT or that VBT obtains hereinafter related shall be VBT property whether credit is extended or not. DATE SIGNATURE DATE CO-APPLICANT'S SIGNATURE (if you are requesting joint credit) VALUEBANK TEXAS (361) 888-4451 (361) 866-7791 Fax www.valuebanktexas.com P.O. BOX 4956, CORPUS CHRISTI, TEXAS 78469-4956 16

" PROJECTED " BUSINESS INCOME & EXPENSE STATEMENT (P&L) (Assume 12 month periods, if requested loan is obtained) BUSINESS NAME: YEAR: 1 YEAR: 2 YEAR: 3 INCOME: $ $ $ Gross Revenue: Less: Returns & Allowances Net Revenue: $ $ - Less: Cost of Goods Sold: Gross Profit: $ $ - Other Income: Total Gross Income: $ $ - EXPENSES: $ $ $ Advertising Car & Truck Expense Commissions & Fees Contract Labor Depreciation Insurance Interest Expense Legal & Professional Licenses & Permits Office Expense Postage Rent Repairs & Maintenance Supplies Telephone Travel & Entertainment Utilities (Electric, Water, Gas, Garbage) Wages (Employee Payroll) Payroll Taxes Property Taxes (Real Estate & Property) Other Expenses: Total Expenses: $ $ - NET PROFIT: $ $ - Estimated Income Taxes: Owners/Officers Withdrawal (W/D) NET PROFIT after W/D & Inc Taxes: $ $ $ - Authorized Signature: Date: 17

ASSUMPTIONS FOR PROJECTIONS BUSINESS NAME Please use this page to explain the assumptions used to generate the three year projection figures. Outline the specific reasons as to why the projected figures differ from previous years for Revenues, Cost of Goods Sold, Other Income, and Operating Expenses. Use the comments section for additional information. EXPLANATIONS: Revenues: Cost of Goods Sold: Other Income: Operating Expenses: Comments: 18

SCHEDULE OF BUSINESS DEBT & OTHER FIXED OBLIGATIONS (SCHEDULE OF NOTES, CONTRACTS, LEASES, ETC PAYABLE) Please furnish information on all mortgage debt, notes, installment debt, contracts, leases, and other fixed obligations. This schedule should be as of the same date as the interim financial statement balance sheet. Total Present Balance should equal the debt shown on the interim financial statement balance sheet. Under status, please indicate whether the loan / lease / or contract is current or delinquent. (Use additional pages, if needed) Creditor Name and Address Account Number Original Date Maturity Date Original Amount Present Loan Balance Int. Rate Payment Frequency No. of Payment Remaining Payment Amount Collateral Status Balance Total Present $ Total Monthly Payment $ Authorized Signature Date 19

SCHEDULE OF MACHINERY, EQUIPMENT, FURNITURE, & OTHER NON-REAL ESTATE ITEMS Please furnish information on all machinery, equipment, furniture, and other non-real estate items. (Use additional pages, if needed) Description, Make or Manufacturer Model Year Serial Number (for items valued $500+) Date Acquired Original Cost Present Value Current Loan Balance Lien Holder Authorized Signature Date 20