BUSINESS LOAN APPLICATION

Transcription

1 BUSINESS LOAN APPLICATION IMPORTANT INFORMATION: Federal law under the USA Patriot Act requires us to obtain sufficient information to verify your identity. You may be asked several questions and to provide one or more forms of identification to fulfill this requirement. In some instances we may use outside sources to confirm this information. The information you provide is protected by our PRIVACY POLICY AND FEDERAL LAW. Dear prospective Applicant: Thank you for your indication that you desire to submit an application to Pacific Enterprise Bank for a business loan. The loan you desire to apply for is described as follows: Application for Loan to ( APPLICANT ): Entity Type (Please check the appropriate box): Individual Corporation General Partnership Limited Partnership Limited Liability Company Sole Proprietorship Trust Other (describe) Guarantor(s) Name(s): Amount of Loan: Purpose of Loan: Collateral Offered, if any: Terms Requested: SIGNATURE: DATE: Attached hereto is a schedule of information we need to process your loan request (please ignore the request as it pertains to such information as you have already provided). Additionally, we have attached several notices for your use. Our form of financial statement must be submitted. To use another form listing and detailing the assets and liabilities of any individual, that individual must: 1) have the other form attached to our form; 2) on our form enter the date of the financial condition, total assets and total liabilities; 3) complete all other portions of our form, and; 4) sign and date our form in the spaces provided. Please return this LOAN APPLICATION along with the other information wherein you have completed and signed the bottom portion. We look forward to the opportunity to approve your loan request and to a long and mutually rewarding banking relationship with you. Yours very truly, Russell J. Smith EVP, COO PEBLNS-19 Business Loan Application Rev of 11

2 LOAN APPLICATION CHECKLIST Thank you for your inquiry about a loan from our bank. Please provide us with the information listed below. The more thoroughly you complete the information the more quickly we will be able to respond. 1. COMPLETED APPLICATION: 2. PERSONAL FINANCIAL STATEMENT(S) Current Date (Form attached): Complete for each guarantor 3. PERSONAL FEDERAL TAX RETURNS (including ALL schedules and ALL K-1s): Last three (3) years for each guarantor 4. BUSINESS FINANCIAL STATEMENTS (Balance Sheet and Income Statement): Last three (3) Fiscal Year ends, PLUS Current interim period 5. CORPORATE FEDERAL TAX RETURNS including ALL schedules and ALL K-1s): Last three (3) years 6. BUSINESS HISTORY and DESCRIPTION (Forms attached): Provide additional information as applicable 7. PROJECTIONS (if available) 8. AGING OF ACCOUNTS RECEIVABLE AND PAYABLE: Current date; same as interim financial statement. 10. DEBT SCHEDULE AS OF INTERIM FINANCIAL STATEMENT DATE (Form attached) AUTHORIZATION To Pacific Enterprise Bank: Please accept herewith my/our application for a loan. The application consists of this submittal and all of the documents specified herein. This application is submitted for the purpose of obtaining credit. I/We hereby certify that all statements in this application are true and complete. I/We authorize Bank, and other companies, financial institutions and networks which Bank may engage to provide my/our loan, to make whatever inquiries about me/us Bank deems necessary and appropriate for the purpose of evaluating my/our credit and reverifying my/our credit from time to time, including obtaining credit bureau reports. I/We also authorize Bank to provide credit information about its credit experience with me/us to other creditors and credit reporting agencies. I/We authorize you verify the accuracy of the statements contained in this application and agreeing that the application shall remain Bank property whether or not the loan is granted. I/We further agree to notify Bank immediately of any material change with regard to said information that may occur while this application is under consideration or while indebted to you. By: Dated: Signature Name/Title By: Dated: Signature Name/Title PEBLNS-19 Business Loan Application Rev of 11

3 APPLICANT COMPANY Legal Business DBA Name (if applicable): Primary Contact: Phone: Cell: Fax: Mailing Address Street City State Zip Physical Address (if different) Type of Entity: Corporation ( S-Corp, C-Corp, LLC) Sole Proprietorship General Partnership Limited Partnership Number of Employees Existing: After this funding: Affiliated Companies? Date Established: Date Incorporated: State of Incorporation: Employer Tax I.D.: OWNERSHIP OF APPLICANT COMPANY -List below all owners, partners, and stockholders with 20% or more ownership interest. Title: Home % of Ownership: Social Security #: DOB: Home Phone: Cell Phone: Applicants must provide a clear copy of either: a driver s license, passport, military I.D., or Alien registration. Please indicate below the form of I.D. that you are attaching to this application. Date of Issue Form of I.D. Place of Issuance Expiration Date Title: Home % of Ownership: Social Security #: DOB: Home Phone: Cell Phone: Applicants must provide a clear copy of either: a driver s license, passport, military I.D., or Alien registration. Please indicate below the form of I.D. that you are attaching to this application. Date of Issue Form of I.D. Place of Issuance Expiration Date Title: Home % of Ownership: Social Security #: DOB: Home Phone: Cell Phone: Applicants must provide a clear copy of either: a driver s license, passport, military I.D., or Alien registration. Please indicate below the form of I.D. that you are attaching to this application. Date of Issue Form of I.D. Place of Issuance Expiration Date Title: Home % of Ownership: Social Security #: DOB: Home Phone: Cell Phone: Applicants must provide a clear copy of either: a driver s license, passport, military I.D., or Alien registration. Please indicate below the form of I.D. that you are attaching to this application. Date of Issue Form of I.D. Place of Issuance Expiration Date (If there are additional owners, please attach on separate sheet) PEBLNS-19 Business Loan Application Rev of 11

4 BANK REFERENCE (Business or Personal) SUPPLIER REFERENCE Bank Company Contact: Contact: Phone #: Phone #: MAJOR CREDITORS (FINANCE COMPANY VENDORS ETC.) Phone #: Phone #: Contact: Contact: Type of Credit: Est: Type of Credit: Est: Current Balance: Monthly Pmt.: Current Balance: Monthly Pmt.: BACKGROUND AND HISTORY OF PRINCIPALS AND COMPANY: NATURE OF BUSINESS, TYPES OF PRODUCTS & SERVICE: MAJOR CUSTOMERS: PRIMARY COMPETITORS: HOW WILL THIS LOAN BENEFIT YOUR COMPANY? PEBLNS-19 Business Loan Application Rev of 11

5 ESTIMATED CREDIT REQUEST (PROJECT COST) ( Uses of Proceeds ) Land Acquisition/ New Building Construction $ Land and Building Acquisition $ Building Improvements/ Repairs $ Acquisition of Machinery/ Equipment $ Acquisition of Furniture/ Fixtures $ Inventory Purchase $ Working Capital (including Accounts Payable) $ Acquisition of an Existing Business $ Debt Refinance: ( ) $ Franchise Fee (s): ( ) $ Estimated Closing Costs and Other Fees: ( ) $ TOTAL ESTIMATED PROJECT AMOUNT $ LESS DOWN PAYMENT from BORROWER (subtract) $ TOTAL LOAN REQUESTED FOR PROJECT $ Notes/ Comments on Estimated Project Costs: PEBLNS-19 Business Loan Application Rev of 11

6 MANAGEMENT RESUME Please fill-in all spaces. If an item is not applicable, please indicate as such. You may include additional relevant information on a separate exhibit. SIGN/DATE where indicated. PERSONAL INFORMATION Social Security #: Date of Birth: Place of Birth: Residence Telephone: Business Telephone: Residence From: To: Previous From: To: Spouse s Spouse Social Security #: Are you employed by the U.S. Government? Yes No Agency/Position: Are you a U.S. citizen? Yes No If no, give alien registration number: EDUCATION College or Technical Training Name Location Dates Attended Major Degree/Certificate From: From: From: To: To: To: MILITARY SERVICE BACKGROUND Branch of Service: Dates of Service: From: To: WORK EXPERIENCE: LIST CHRONOLOGICALLY WITH PRESENT EMPLOYMENT. Company From: To: Title/Position: Duties: Company From: To: Title/Position: Duties: Company From: To: Title/Position: Duties: Signature: Business Date: PEBLNS-19 Business Loan Application Rev of 11

7 ANNUAL FAMILY BUDGET (LIVING EXPENSE NEED/DRAW) Income Expenses Officer s Salary/Owner s Draw $ Spouse Salary $ Rental Income $ Other: $ Other: $ TOTAL ANNUAL INCOME $ Mortgage Payment (all owned properties) $ Property Taxes (all owned properties) $ Other Term Debts $ Installment Accounts (credit cards) $ Auto Loan $ Auto Expenses (gas, maintenance, etc.) $ INSURANCE Medical $ Dental $ Life $ Auto $ Food $ Clothing $ Utilities (telephone, gas, electric, water, trash) $ Income Tax (Federal & State) $ Other: $ Miscellaneous: $ TOTAL ANNUAL EXPENSES $ DISPOSABLE INCOME $ PEBLNS-19 Business Loan Application Rev of 11

8 BUSINESS DEBT SCHEDULE Company Name Date Indebtedness. Furnish the following information on all installment debts, contracts, notes, and mortgages payable. Indicate with an asterisk (*) items to be paid by loan proceeds and reason for paying same. Do not include accounts payable or accrued liabilities. ACCOUNT NUMBER AND TO WHOM PAYABLE ORIGINAL AMOUNT ORIGINAL DATE BALANCE DUE INTEREST RATE MAUTRITY DATE MONTHLY PAYMENT SECURITY (How were proceeds used) STATUS Signature: Print Date: PEBLNS-19 Business Loan Application Rev of 11

9 To: Pacific Enterprise Bank PERSONAL FINANCIAL STATEMENT From: For the purpose of procuring and establishing credit from time to time with you, each of the undersigned furnish the following as a true and accurate statement of the financial condition of the undersigned AS OF (DATE). If married, you may apply for credit with or without your spouse s signature. Your community property will be responsible for the obligation whether or not your spouse signs unless you apply for separate credit. Both Husband and Wife should initial if applicable: WE INTEND TO APPLY FOR JOINT CREDIT. (INITIALS) Pacific Enterprise Bank ASSETS Cash Accounts Receivable Notes Receivable-Current Marketable Securities (Provide detail in the Schedule of Stocks and Bonds.) LIABILITES Accounts and Bills Payable Short Term Notes Payable - Banks Short Term Notes Payable - Other Credit and other charge cards payable Due to Relatives and/or Friends Other Current Assets (describe*) TOTAL CURRENT ASSETS $ Taxes payable Automobile(s):yr., make, model Stocks & Bonds Not Listed on Exchanges, Partnerships & LLCs (describe*) Real Estate (Provide detail in the Schedule of Real Estate) Due from Relatives and/or Friends Year: Make: Model: Other Current Liabilities (describe*) TOTAL CURRENT LIABILITIES $ Mortgages or Other Liens on Real Estate (Provide detail in the Schedule of Real Estate) Notes Secured by Personal Property (show current portion in other current liabilities) Other Non-current Liabilities (describe*) Notes Receivable-Long Term TOTAL LIABILITIES $ Other Assets (describe*) TOTAL NET WORTH $ TOTAL ASSETS $ TOTAL LIABILITIES & NET WORTH $ DISCLOSURES: Are any of the above listed assets or liabilities held in Joint Tenancy, Tenancy in Common, or in a Trust? Yes No If yes, please provide details: Married persons: Please identify any separate property assets and liabilities: PERSONAL INFORMATION Date of Birth: Do you have a will? Yes No Have you established a trust? Yes No Married Unmarried Separated Spouse s name, if married: Date of Birth Have you ever failed in business or compromised debts with your creditors? Yes No Have you ever filed bankruptcy? Yes No Are any of your assets pledged, or in any other manner unavailable for paying debts? Yes No Are you contingently liable (for example as a co-signor or guarantor) for any debts of another person or entity? Yes No Are there any lawsuits, judgments, etc. against you? Yes No Are you delinquent on any of your obligations? Yes No *DESCRIPTIONS & EXPLANATION(S): Please describe specified assets and liabilities and/or explain any Yes answer(s) above: Please attach additional sheets as necessary. Citizenship: U.S. Other If other, provide nationality and explain residency status: CDL or other govt. issued ID#: or Passport#: Expires: Expires: PEBLNS-19 Business Loan Application Rev of 11

10 PERSONAL FINANCIAL STATEMENT CONTINUED ANNUAL INCOME AND EXPENSE FOR PERIOD FROM: TO: Annual Income Annual Expenses Salary $ Interest $ Rentals Taxes & Assessments Dividends Interest Income Other Income (You do not need to include income from alimony and child support unless you want the Bank to consider it for the purpose of this application for credit.) Explain below. Upkeep on Real Estate Payments on Mortgages & Notes Rent Personal Living Expenses Other Expenses Total Income: $ Total Expenses $ SCHEDULE OF STOCKS AND BONDS No. of Shares Description Issued in the Name of Exchange Market Value Total: $ $ Are you aware of any restrictions on the transfer or sale of the above securities? Yes No If yes, provide details: Please provide additional sheet(s) as necessary SCHEDULE OF REAL ESTATE Address Title Vested in Name of Description Date PurchasedPurchase Price Market Value Unpaid Balance Monthly Payment Total $ Please provide additional sheet(s) as necessary EMPLOYMENT Employer s Name Job Title/Description of Duties Employer s Employer s Phone #: Employed Since PERSONAL REFERENCES (please provide two, non-relatives) Name Address Phone # Relationship Representations and Warranties: This financial statement is provided to Pacific Enterprise Bank ( Bank ) for its review of my/our creditworthiness, and Bank can rely on its contents. I/We hereby warrant to Bank that this financial statement is complete and correct as of the date prepared and fairly represents my/our financial condition and that I/We will promptly inform Bank of any material changes in the information provided, including transfer of any assets into a trust. I/We authorize Bank, and other companies, financial institutions and networks which Bank may engage to provide my/our loan, to make whatever inquiries about me/us Bank deems necessary and appropriate for the purpose of evaluating my/our credit and reverifying my/our credit from time to time, including obtaining credit bureau reports and contacting my/our employer(s). I/We also authorize Bank to provide credit information about its credit experience with me/us to other creditors and credit reporting agencies. SIGNATURES Spouse s signature required only if you and your spouse are or will be jointly obligated on credit extended by Pacific Enterprise Bank. Signature: X: SS#: Spouse s Signature: X: Spouse SS#: Date Signed: Home phone#: Date Signed: Home phone#: Work phone#: Cell phone#: EXPLANATION(s) (cont d): Please provide details and/or explain any Yes answer(s) above: Work phone#: Cell phone#: PEBLNS-19 Business Loan Application Rev of 11

11 Please keep this page for your records IMPORTANT DISCLOSURE INFORMATION USA Patriot Act IMPORTANT ACCOUNT OPENING INFORMATION: Federal law under the USA Patriot Act requires us to obtain sufficient information to verify your identity. You may be asked several questions and to provide one or more forms of identification to fulfill this requirement. In some instances we may use outside sources to confirm the information. The information you provide is protected by our PRIVACY POLICY AND FEDERAL LAW EQUAL CREDIT OPPORTUNITY ACT (ECOA) 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 (provided 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 the 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 credit is: Federal Reserve Consumer Help Center, P.O. Box 1200, Minneapolis, MN 55480, toll-free number: (888) , fax number: (877) , TDD number: (877) NOTICE OF THE RIGHT TO REQUEST SPECIFIC REASONS FOR CREDIT DENIAL You have the right to a written statement of reasons we were unable to approve your application. You have 60 days from the date of our notification to you of adverse action to make a written request for a statement of the reasons. If you would like a statement of specific reasons why your application was denied, please contact Russell J. Smith, our Chief Credit Officer at the address provided. We will provide you with the statement of reasons within 30 days after receiving your request. If you have any questions regarding this notice, you should contact us at Pacific Enterprise Bank, Skypark Circle, Suite 100, Irvine, CA Attn: Russell J. Smith, Chief Credit Officer, Phone: (949) NOTICE TO APPLICANT OF RIGHT TO RECEIVE COPY OF APPRAISAL for Loans Secured by a First-Lien on Residential Real Property: We may order an appraisal to determine the property s value 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. CALIFORNIA NOTICE TO APPLICANT OF RIGHT TO RECEIVE COPY OF APPRAISAL for Loans Secured by a Subordinate Lien on Residential Real Property: You have the right under Section of the California Business and Professional Code to a copy of the appraisal we obtained in support of your application for credit, provided that you have paid for the appraisal. If you would like a copy, please write to us at Pacific Enterprise Bank, Skypark Circle, Suite 100, Irvine, CA Attn: Russell J. Smith, Chief Credit Officer. We must hear from you no later than 90 days after we notify you about the action taken on your credit application or send you a notice of incomplete application. If you withdraw your application, you must make your written request for a copy of the appraisal within 90 days of the withdrawal. If you request a copy of your appraisal, and you have paid for the cost of the appraisal, we will send you a copy to the address shown on your loan application. CALIFORNIA NOTICE TO APPLICANT OF RIGHT TO RECEIVE COPY OF APPRAISAL for Non Residential Real Property: You have a right under Section of the California Business and Professions Code to a copy of the appraisal report obtained by this bank in support of your application for credit, provided that you have paid for the appraisal and the cost of duplicating the appraisal. In order to obtain a copy of your appraisal, write to us at Pacific Enterprise Bank, Skypark Circle, Suite 100, Irvine, CA Attn: Russell J. Smith, Chief Credit Officer. We must hear from you no later than 90 days after we notify you about the action taken on your credit application, including notice of an incomplete application. If you withdraw your application, you must make your request for an appraisal report within 90 days of the withdrawal. If you request a copy of your appraisal report, and you have paid for the costs of the appraisal, we will send you a copy at the address shown on your loan application. You are only entitled to receive a copy of the appraisal report for purposes of evaluating your pending request for an extension of credit with this bank. HOME MORTGAGE DISCLOSURE ACT NOTICE: The HMDA data about our residential mortgage lending are available for review. The data show geographic distribution of loans and applications; ethnicity, race, sex, and income of applicants and borrowers; and information about loan approvals and denials. Inquire at Pacific Enterprise Bank, Skypark Circle, Suite 100, Irvine CA regarding the locations where HMDA data may be inspected. To receive a copy of this data send a written request to this same address Attn: Russell J. Smith, Chief Credit Officer. Pacific Enterprise Bank, PEBLNS-19 Business Loan Application Rev of 11