WESTERN COMMERCE BANK

Transcription

1 WESTERN COMMERCE BANK Business Loan Application Eddy County Lea County Bernalillo County 127 S. Canyon St North Turner 1910 Wyoming Blvd. NE Carlsbad, NM Hobbs, NM Albuquerque, NM Phone (575) Phone (575) Phone (505) Fax (575) Fax (575) Fax (505) Corporate Mailing Address WESTERN COMMERCE BANK PO Box 1358 Carlsbad, NM Thank you for choosing Western Commerce Bank to meet your financial goals. Our Commercial Lending team specializes in meeting the financial needs of small businesses and their owners. Through a variety of financial solutions, our goal is to help your business grow. In order for us to consider your loan request and to allow us to analyze and structure a loan according to your needs, we will need the following: 1. Loan Request Form 2. Applicants Information Sheet 3. Copy of 2 forms of identification for each individual. Examples: Picture ID, driver s license, social security card. 4. Personal Financial Statement Complete on all owners, corporate officers, Guarantors, and stockholders with 20% or more total stock issued (copy form as needed) 5. Personal History Statement Complete on all individuals referred to in #2 above, management and directors (copy form as needed) 6. Personal Tax Returns previous 3-years signed and dated 7. Provide Resume with detailed job descriptions on all individuals referred to in # s 2 and Borrower s Credit Report Authorization on all individuals referred to in # s 2 and 3. (copy form as needed) 9. History of the business & Reference List Year s Forecasted Earnings (form enclosed) 11. Business Plan, including projections of Income & Finances 12. Notes Payable Schedule The figures in the Balance Due column of the schedule should coincide with note balances in the Interim Business Financial Statements. 13. Subsidiaries and Affiliates Listing - include names, addresses, concerns in which the applicant holds a controlling (but not necessarily a majority) interest and other concerns that may be affiliated by stock ownership, franchise, and proposed merger or otherwise with the applicant, if applicable. 14. Organizational Documents Including Borrowing Authority and Meeting Minutes a. Corporation: Articles of Incorporation and By-Laws b. Limited Liability Company Articles of Organization and Operating Agreement c. Limited Liability Partnership Articles of Agreement and Operating Agreement 15. Interim Business Financial Statement dated within 60 days. 16. Business Income Statements - Balance sheets & Profit & Loss Statements for 3 prior fiscal year-ends and complete tax returns with all appropriate schedules 17. Business Tax Returns previous 3-years, signed and dated Public Folder/Business Loans/Application Request forms/application Package docs. Revised 10/2010 1

2 18. Insurance (provide copies of insurance policies) a. Flood Insurance Policy (if applicable) b. Property & Casualty c. Commercial General Liability d. Automobile Liability e. Life Insurance Policy f. Or any other that may apply 19. Copy of Business License 20. Purchase Agreement (If Business Acquisition). a. Current Balance Sheet and Profit and Loss Statement of business to be purchased b. Previous 2-years Federal Income Tax Returns of the business to be purchased c. Proposed Bill of Sale, including terms of sale d. Asking price with detailed schedule of value assigned for: aa. Inventory bb. Machinery and Equipment cc. Furniture and Fixtures dd. Other 21. Uniform Franchise Offering Circular (if applicable). 22. Executed Franchise Agreement or Letter of Approval from Franchisor (if applicable). 23. Copy of Business Lease or letter from landlord giving terms of proposed lease 24. Are any officers or principals owning 20% or more of the business involved in any pending lawsuits? Yes No If yes. Please provide details. 25. Have any officers of principals owning 20% or more of the company ever been involved in bankruptcy or insolvency proceedings? Yes No If yes, please provide details. 26. Retirement Plan: Yes No ; Previous SBA Financing: Yes No If yes, please provide details. Public Folder/Business Loans/Application Request forms/application Package docs. Revised 10/2010 2

3 Loan Request Form APPLICANT COMPANY Western Commerce Bank Company Name Telephone Day-to-Day Manager Telephone Complete Address Name of Franchise Name of Franchise Representative Type of Entity: Corporation Partnership Limited Liability Company Sole Proprietorship Date Established Number of Employees: Existing After this Loan Tax ID: SSN: Accountant s Name Telephone Insurance Carrier: Telephone Life Insurance Carrier Life Insurance Policy Amount $ EXISTING BUSINESSES: Gross Receipts Net Income 2007 $ $ 2008 $ $ 2009 $ $ 2010 YTD $ $ OWNERSHIP OF APPLICANT COMPANY List below all owners and/or managers titles and percentage (%) of ownership. Managers to be listed even if no ownership percentage in the business. Use separate sheet if more than 4. NAME TITLE % OF OWNERSHIP AFFILIATES List below all business concerns in which the Applicant Company or any of the individuals listed in the ownership section above have any ownership. Use separate sheet if more than 4. COMPANY NAME OWNER % OF OWNERSHIP (APPLICANT COMPANY OR INDIVIDUALS) ESTIMATED PROJECT COSTS *Purchase Land *Purchase Land & Improvements *Purchase Improvements *Construct a Building *Add an Addition to a Building *Make Renovations to a Building *Pay Off Interim Construction Loan *Pay Off Lender s Interim Loan *Make Leasehold Improvements to a Building Purchase machinery/equipment Purchase Fixtures Purchase Inventory Pay Trade or Accounts Payable Pay Notes Payable Pay Outstanding Debt Purchase a Business Purchase all Outstanding Stock Pay SBA Loan Working Capital Franchise Fee Closing Costs (Approximately 3-5% of Loan Amount) TOTAL PROJECT AMOUNT LESS CASH/EQUITY TO BE INJECTED BY APPLICANT TOTAL LOAN REQUESTED FOR PROJECT [$ ] *Must include water/sewer source information Public Folder/Business Loans/Application Request forms/application Package docs. Revised 10/2010 3

4 GENERAL BUSINESS DISCLOSURES CREDIT REPORT AUTHORIZATION I/We hereby authorize Western Commerce Bank to check my/our personal credit and employment history and/or have a credit-reporting agency prepare a credit report on me/us. I/We also acknowledge that Western Commerce Bank will verify the creditworthiness of the Business Entity, if any, associated with this loan request, as well as any payoffs that be deemed necessary for this loan request. Social Security # Physical Address Driver s License # State DOB Social Security # Physical Address Driver s License # State DOB Social Security # Physical Address Driver s License # State DOB Social Security # Physical Address Driver s License # State FINANCING STATEMENT AUTHENTICATION I/We, Debtor, hereby authorize Western Commerce Bank, Secured Party, to file a Financing Statement covering Debtor s Property to be pledged as collateral for this loan request. Debtor will comply with, facilitate, and otherwise assist Secured Party in connection with obtaining possession or control over the Property for purposes of perfecting Secured Party s interest under the Uniform Commercial Code. ACKNOWLEDGEMENT OF NEW MEXICO LAW CONCERNING WRITTEN AGREEMENTS I/We hereby acknowledge that I/We are aware that New Mexico Law (Laws 1990, Chapter 45, Section 1) provides: A contract, promise or commitment to loan money or grant, extend or renew credit or any modification thereof, in an amount greater than twenty-five thousand dollars ($25,000.00), not primarily for personal, family or household purposes, made by a financial institution shall not be enforceable unless in writing and signed by the party to be charged or that party s authorized representative. Public Folder/Business Loans/Application Request forms/application Package docs. Revised 10/2010 4

5 APPLICANT'S INFORMATION SHEET COMPANY NAME/DBA TYPE OF BUSINESS BUSINESS ADDRESS CITY STATE ZIP DAY PHN FAX USE OF PROCEEDS ADDRESS CITY STATE ZIP PROPRIETORSHIP PARTNERSHIP CORPORATION LLC Trust TAX ID # NAMES OWNER / PRINCIPALS % OWNERSHIP / TITLE How many employees do you have? How many employees will you hire? Have you ever applied for government financing? If so please provide the name of the agency, original balance, and if loan is current? Vesting if R/E Purchase Title/Escrow/Attorney Business Bank Name / Address USE OF PROPOSED LOAN: HOW WILL THIS LOAN BENEFIT YOUR BUSINESS? Public/Loan Information/All Business Loan Types/Application Request Forms/Loan Packets

6 SBA - HISTORY OF BUSINESS Western Commerce Bank Use a separate attachment to answer questions if necessary NATURE OF BUSINESS WHEN AND HOW WAS BUSINESS ESTABLISHED? TYPES OF PRODUCTS / SERVICE CUSTOMER PROFILE LIST KEY CUSTOMERS LIST MAJOR COMPETITORS MAJOR SUPPLIERS GEOGRAPHICAL SALES AREA MAJOR PAST ACCOMPLISHMENTS FUTURE PLANS FOR GROWTH / EXPANSION HOW WILL THIS LOAN BENEFIT YOUR COMPANY? Will the funding of the Loan Create New Employment Opportunities? Yes No If yes, State how below:

7 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: NAME SS# DATE OF BIRTH PLACE OF BIRTH RESIDENCE TELEPHONE BUSINESS TELEPHONE RESIDENCE ADDRESS FROM TO PREVIOUS ADDRESS FROM TO SPOUSE'S NAME ARE YOU EMPLOYED BY THE US GOVERNMENT? SS# AGENCY/POSITION ARE YOU A CITIZEN: IF NO, GIVE ALIEN REGISTRATION # EDUCATION: High School./College/Technical-Name/Location Dates Attended Major Degree/Certificate MILITARY SERVICE BACKGROUND: Branch Of Service Dates of Service WORK EXPERIENCE: List chronologically beginning with present employment. Company Name/Location From To Title Duties Company Name/Location From To Title Duties Company Name/Location From To Title Duties Signature Date

8 WESTERN COMMERCE BANK P.O. BOX 1358 CARLSBAD, NM CONFIDENTIAL FINANCIAL STATEMENT FOR INDIVIDUALS ONLY NAME DATE OF BIRTH SOCIAL SECURITY # HOME PH# ADDRESS NAME OF SPOUSE SOCIAL SECURITY # EMPLOYMENT & ADDRESS YEARS POSITION FINANCIAL CONDITION AS OF, 20 PLEASE DO NOT LEAVE ANY QUESTIONS UNANSWERED. ASSETS LIABILITIES OMIT CENTS CASH, CHECKING. NOTES PAYABLE ON HAND UNSECURED SAVING, CD TO FINANCIAL (SCHEDULE 1) FINANCIAL INSTITUTIONS INSTITUTIONS (SCHEDULE 4) SECURED SECURITIES MARKETABLE SECURITIES OTHER NOTES OR UNSECURED (SCHEDULE 2) ACCOUNTS OTHER STOCKS & BONDS PAYABLE (SCH 4) SECURED REAL PERSONAL RESIDENCE ESTATE OTHER PROPERTIES MORTGAGES (SCHEDULE 5) MTG. ON PERSONAL RESIDENCE PAYABLE PARTIAL INTEREST IN R/E OR JOINT (SCHEDULE 5) MTG. ON OTHER PROPERTIES OMIT CENTS ACCOUNTS/NOTES RECEIVABLE (SCH 3) CASH VALUE OF LIFE INSURANCE (SCH 7) AUTOMOBILES - NUMBER OF AUTOMOBILES IRA/RETIREMENT ACCOUNTS PARTIAL INTEREST IN R/E TAXES INCOME TAXES OWING OTHER TAXES OTHER LIABILITIES (ITEMIZE) PERSONAL ASSETS CROP & LIVESTOCK (SCH 6) OTHER ASSETS TOTAL ASSETS ANNUAL INCOME SALARY OR WAGES BONUS & COMMISSION DIVIDENDS AND INTEREST AND ANNUITY NET RENTAL OR LEASE INCOME SOCIAL SECURITY OTHER INCOME (DETAIL) TOTAL LIABILITIES NET WORTH TOTAL LIABILITIES & NET WORTH LISTED ON FEDERAL INCOME TAX RETURNS LAST YEAR THIS YEAR PROJECTIONS TOTAL INCOME TOTAL AMOUNT OF INCOME TAX PAID $ FEDERAL $ STATE $ ARE ANY ASSETS OTHER THAN REAL ESTATE AND SECURITIES PLEDGED? IF YES, PLEASE EXPLAIN ON PAGE 4. YES OR NO? THE ABOVE FINANCIAL AND SUPPORTING SCHEDULES, WHICH ARE SUBMITTED FOR THE PURPOSE OF ESTABLISHING, OBTAINING, AND MAINTAINING CREDIT, PRESENT A TRUE, COMPLETE AND CORRECT STATEMENT OF MY FINANCIAL CONDITION AS OF THE DATE SHOWN. I AGREE TO NOTIFY THE BANK OF ANY MATERIAL ADVERSE CHANGE IN MY FINANCIAL CONDITION, AND TO FURNISH CURRENT FINANCIAL INFORMATION UPON REQUEST BY THE BANK FROM TIME TO TIME. THE BANK IS AUTHORIZED TO CONTACT AN APPROPRIATE THIRD PARTIES FOR THE PURPOSE OF VERIFYING ANY INFORMATION AT ANY TIME FURNISHED BY ME TO THE BANK. SUCH FINANCIAL STATEMENT AND OTHER INFORMATION FURNISHED SHALL BE THE PROPERTY OF THE BANK. DATE DATE SIGNATURE SIGNATURE Revised LLF 1 of 4

9 Exhibit 02.c REFERENCE LIST _ Borrower: Hm &/Cell Phone # s: Co-Borrower: Hm/Cell Phone # s: Date of Birth: SS# Driver s License # State Date of Birth: SS# Driver s License # State For loan servicing purposes, please indicate the names and street addresses of your nearest relatives, and other personal references that we may contact if the need arises to properly service your account. Please do not list two references in the same household. All references should have different addresses and phone numbers. If mail is NOT received at a street address, ALSO include the PO Box. My Two Nearest Relatives: (1) ( ) Name Relationship Area Code Phone # Address: Street and PO Box, if applicable City State Zip (2) ( ) Name Relationship Area Code Phone # Address: Street and PO Box, if applicable City State Zip My Two Personal References: (1) ( ) Name Relationship Area Code Phone # Address: Street and PO Box, if applicable City State Zip (2) ( ) Name Relationship Area Code Phone # Address: Street and PO Box, if applicable City State Zip Thank You, Western Commerce Bank Loan Servicing P:\LOAN Information\All RE Info\All RE Loan Disclosures\Master Disclosures\Reference List 2-11