Loan Application. Russell County Loan Fund

Transcription

1 Loan Application Russell County Loan Fund Name of Applicant: Address: Town, Zip: Phone: Name of Business: Address: Town, Zip: Phone: Federal Tax I.D Number Type of Business: Date Established: Number of Employees: Current: Retained: Creating: Bank of Business: Name: Account Type: Address: Town, Zip: List all banks, types of accounts, and full addresses. Attach additional sheets if necessary. Project Budget (Use of Funds) Micro-loan Personal Sources Total Loan Micro loan Fund Personal Injection Other* Land acquisition Construction/ Expansion/Repair

2 Contingencies Specify: Machinery & Equip. Inventory Purchase Working Capital Acquisition of Existing Business Other: Total Project Cost: Term of Loan years years Interest Rate % % *Attach sheet listing sources of other funds.

3 List of Collateral Present Market Value Present Loan Balance Cash Prepaid Expenses Land & Building Machinery & Equipment Furniture & Fixtures Accounts Receivable Inventory Other Total Please provide an itemized list of all collateral, including legal description on real estate and make, model and the serial number of all items. Attach information to support the values listed (appraisals, bills of sale, depreciation schedules) Indebtedness Summary To whom payable Name Address City, State, Zip Original Amt borrowed Original date borrowed Present balance Rate of interest Payoff Date Monthly Payment Pledged Security Current or past due? (If past due, enter amount owed)

4 Statement of Ownership Place an asterisk (*) beside each individual s name involved in day to day management (Attach separate sheets if necessary) % Of Ownership Name/Address Name/Address Name/Address Name/Address

5 Checklist: Information which must be supplied by the individual(s) seeking loan: 1. Letters of commitment or personal injection and other source(s) of financing including availability of funds. 2. Business plan. (Small Business Development Center format is suggested) 3. Business Financial Statements (income and balance sheet) three (3) years historical 4. Current (not less than 60 days) financial statement 5. Projected business financial statements both income and balance for 3 years 6. 3 years of business tax returns or if new business 3 years of personal tax returns 7. Aging of accounts receivable and payable (existing business) 8. Personal financial statement (owners of 20% or more and new investors) 9. Resume of management, including education, work experience, and management ability 10. Written history of business, including ownership type, parent or subsidiary relationships, location, product line, markets, and benefits company will derive from approval of loan 11. Itemization of project cost from page 1 of application form 12. Purchase agreement (executed) may state contingent upon purchaser receiving financing 13. Letter of commitment for other sources of financing 14. Franchise agreement (if applicable) 15. Lease agreement (if applicable) 16. Current and projected employee listing 17. Authority to automatically debit business account for Micro Loan Payment (attach cancelled check or deposit slip)

6 Please answer the following questions and read the following assurances: 1. Have you ever filed bankruptcy? Yes ; No If yes, please explain when, amount, and circumstances. 2. Does the business have any pending law suit(s)? Yes ; No 3. Are there any tax liens filed against you or the business? Yes ; No 4. Do you have any controlling interest in another business: Yes No If yes, will the existing/proposed business buy from or sell to this concern? Yes ;No I (we) do hereby certify that the information contained in this application is true and correct. By signing below I authorize you to check my credit history and to answer questions others may ask you about my credit record. Applicant Print or Type Name Date

7 Russell County and Ecommunity Loan Application Scoring System SCORING RUBRIC The Financial Review Board will use this rubric to score all applications made for funds through the Russell County Loan Application and Ecommunity Program. Criteria Strength (1-4) Weight (% of total) Weighted Score Financial Soundness 15 Owner/Operator 10 Experience Business Plan 10 Projected Growth & 25 Economic Impact Business Development 10 Partnerships Quality of Life Impact 10 Owner/3 rd Party Funding 10 Community Commitment 10 TOTAL RUBRIC GUIDELINES SCALE 4 = Exceeds expectations 3= Meets expectations 2= Partially meets expectations 1= Does not meet expectations GLOSSARY OF TERMS Financial Soundness This will be determined by examining applicant s financial statements Owner/Operator Experience This will include a review of resumes and references as well as the interview process. One resume and three references will be required with each application. Business Plan All business plans should include key elements such as: Executive Summary

8 Business Description Products or Services Project Financing Management Ownership Marketing Strategy Description of Major & Prospective Customers Description of Market & Competition Financial Information Contact List name/number for KSBDC, Enterprise Facilitation, etc.. for assistance in developing your business plan, List phone number. Projected Growth & Economic Impact This will be based on applicant s identified long-term and short-term goals and financial information. Business Development Partnerships We will be looking for applicant s use of local/regional NetWork Kansas resource partners during the planning and implementation process (i.e. working with Kansas Small Business Development Center, local Economic Development organizations, Kansas Department of Commerce Business Development, Enterprise Facilitation and others available to help entrepreneurs. Resource partner list found at Quality of Life Impact These questions will help determine the Quality of Life score: Does the business provide an unfulfilled need within the community/county? Does the business expand upon current business offerings? Does the business provide jobs for highly skilled and or educated employees? Will the business enrich the community with aesthetically and environmentally friendly facilities? Owner/3 rd Party Funding This will be based on information in the applicant s financial statements. Community Commitment Does or will the business participate in local organizations and projects through membership, volunteerism or financial contributions? Is applicant a member of the Chamber of Commerce?

9 Russell County Loan Program Terms and Guidelines Applicants must be opening a new business or expanding a current business in Russell County, Kansas. Applicants must provide a business plan, 3-5 years of projected financials, and 3 years of tax returns. (If new business, 3 years of personal tax returns. If current business, 3 years of tax returns on the business). Further explanation given in glossary of terms in scoring rubric. Applicants much make one contact with the Kansas Small Business Center, KSBDC, at Fort Hays State University. Terms: Loan can be up to the amount of $15,000 at 4% interest over 5 years. Secured: Collateral is required. Review committee can approve or decline the application due to lack/type of collateral. *If business sells but stays in Russell County, Kansas, and loan is not paid off, owner must contact Russell County Eco Devo and CVB within 15 days to set up payment agreement. If business sells and is moved out of Russell County, Kansas, the balance of the loan with Russell County Eco Devo and CVB is due immediately.