Business Loan Application Form

Business Loan Application Form

WHEREAS

WHEREAS Applicant Name: seeks financing to support business operations and growth; and

WHEREAS Lender Name: is willing to review and consider the financing request subject to credit approval and the terms set forth herein; and

WHEREAS the parties intend for the information provided in this application to be relied upon by Lender in determining creditworthiness and loan terms.

Applicant / Business Information

Corporation LLC Partnership Sole Proprietor Other

Primary Contact / Principal Owner

Loan Request & Scope of Use

Payment Terms (Proposed)

Loan Amount:   Payment Frequency:   Installment Amount:

Late Fee: assessed on late payments after days past due.

Applicant acknowledges that final payment terms, interest rate, amortization schedule, and late fee provisions will be set by Lender in any credit agreement, and Applicant's requested terms do not constitute an offer by Lender.

Term and Termination (Proposed)

Proposed Start Date:   Proposed Maturity Date:

Notice Period for Termination by Lender: days after issuance of written notice. Final term and termination provisions will be governed by the definitive loan documents executed by the parties.

Financial Summary

Declarations & Certifications

Has the business or any principal ever filed for bankruptcy?   Yes No

Are there any unresolved tax liens, judgments, or civil suits against the business or principals?   Yes No

Certification: By signing below, Applicant certifies that all information provided in this application is true and complete to the best of Applicant's knowledge, that Applicant understands that Lender will rely upon such information in evaluating this application, and that Applicant authorizes Lender to obtain credit reports, bank references, and other information necessary to verify statements made herein. Applicant further acknowledges that submission of this application does not obligate Lender to extend credit.

Applicant authorizes lenders, credit agencies, and financial institutions to release credit and financial information to Lender for the purpose of credit evaluation. Applicant acknowledges that a copy of this authorization shall be as valid as the original.

Consent to Credit Inquiry: Applicant hereby consents to credit inquiries and authorizes release of consumer and business credit reports to Lender.

Confidentiality

All non-public financial information provided by Applicant to Lender pursuant to this application will be treated as confidential by Lender in accordance with Lender's privacy practices, except as permitted or required by law, or as necessary to obtain credit reports, appraisals, or other third-party services in connection with the loan evaluation.

Governing Law and Entire Agreement

Governing Law: This application and any dispute arising from its contents shall be governed by and construed in accordance with the laws of the state of , without regard to conflict of law principles.

Entire Agreement: Applicant acknowledges that any subsequent loan agreement, promissory note, security agreement, or other definitive documents executed by the parties will constitute the entire agreement between the parties with respect to the loan, and this application serves solely as the Applicant's request and certification of information for such evaluation.

Additional Information & References

Certification and Signature

By signing below, Applicant certifies under penalty of perjury that the information contained in this application and any attachments is true, complete, and correct. Applicant authorizes Lender to verify any information provided and to obtain credit and background reports as necessary.

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