Borrow Program Application Form

Borrow Program Application Form

WHEREAS, the Borrow Program (the Program) is established to provide short-term financing to eligible small businesses and individuals for working capital, operational needs, or project-specific expenses; and

WHEREAS, Applicant seeks consideration for financial assistance under the Program and agrees to provide accurate, complete information and to comply with the Program's application requirements, certifications and consent provisions herein; and

WHEREAS, the Program will evaluate applications in accordance with stated eligibility criteria, credit and background checks, and may impose terms and conditions upon approval including repayment obligations and reporting requirements.

Applicant Information

Individual   Sole Proprietorship   Partnership   Corporation   LLC   Nonprofit

Program Request

Security and Financial Information

Eligibility and Certifications

By submitting this application, Applicant certifies under penalty of perjury that the information provided in this application and any attachments is true, complete, and accurate to the best of Applicant's knowledge. Applicant authorizes reasonable verification, background and credit checks, and release of relevant information to third parties as necessary to evaluate this application.

I certify the information provided is true and complete.

I authorize credit and background checks as part of application review.

My business or I am not currently in bankruptcy and have no outstanding judgments that would disqualify me from the Program.

I will provide financial statements and additional documentation upon request and certify such documents are accurate.

Payment Terms (If Approved)

Upon approval of this application, Applicant will be provided a written loan agreement specifying the final loan amount, repayment schedule, interest rate (if any), and any fees. Unless otherwise provided in the written loan agreement, late payments shall incur a late fee equal to the lesser of five percent (5%) of the past due amount or $50.00, and interest on overdue amounts shall accrue at a rate of 1.5% per month (18% per annum) or the maximum permitted by applicable law.

Term and Termination (Program Participation)

If Applicant is approved and accepts the Program offer, the term of the loan or funding shall be set forth in the funding agreement. The Program reserves the right to terminate or suspend disbursement or participation for material misrepresentation, failure to timely provide requested documentation, insolvency, or violations of the funding agreement. Notice of termination will be provided in writing and, unless otherwise required, termination will become effective upon receipt of such notice or as set forth in the funding agreement.

Confidentiality

Information provided in this application and supporting documents will be treated as confidential and used solely for the purpose of evaluating eligibility and administering the Program, except where disclosure is required by law, regulation, or lawful request of governmental authorities, or is necessary to effectuate credit reporting, collections, or third-party verification. The Program may disclose applicant information to its advisors, lenders or guarantors under confidentiality terms.

Governing Law and Entire Agreement

This application, any attachments, and any subsequent funding agreement shall be governed by and construed in accordance with the laws of the State specified below without regard to conflicts of law principles. This application and any approved funding agreement shall constitute the entire agreement between Applicant and the Program with respect to the subject matter and supersede all prior communications and understandings.

Acknowledgment and Signature

Applicant acknowledges that submission of this application does not constitute approval or an obligation to fund. Applicant agrees to immediately notify the Program of any material change to the information provided. Applicant consents to the use and disclosure of applicant information for the purposes described above and understands that false statements may result in denial of the application or rescission of an approved funding offer.

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