COMMERCIAL LOAN APPLICATION: Fill this out, Now. Thank you

SECTION 1 — BUSINESS INFORMATION Legal Business Name:

DBA (Doing Business As):

Business Address:

City / State / Zip:

Business Phone:

Business Email:

Website:

Issued: Revenue: Financing

Federal EIN:

Business Structure:

Other

Industry Type:

Date Business Started:

Number of Employees:

Monthly Revenue:

Current Business Bank:

SECTION 2 — PRIMARY CONTACT / OWNER INFORMATION Full Legal Name:

Title/Position:

Ownership Percentage:

Mobile Phone:

Email Address:

Home Address:

Social Security Number (if required):

Driver’s License Number:

State Issued:

SECTION 3 — LOAN REQUEST DETAILS Type of Financing Requested:

Other

Requested Loan Amount:

Desired Funding Timeframe:

Immediately
Within 7 Days
Within 30 Days
Flexible

Purpose of Funds:

Other

Describe How Funds Will Be Used:

SECTION 4 — PROPERTY INFORMATION (Complete only for Commercial Real Estate Loans) Property Type:

Other

Property Address:

Purchase Price / Estimated Value:

Down Payment Available:

Occupancy Type:

Owner Occupied
Investment Property

SECTION 5 — CURRENT BUSINESS DEBT

Creditor, Original Amount, Current Balance, Monthly Payment

SECTION 6 — BANKING & CREDIT PROFILE Average Daily Bank Balance:

Current Credit Score Range:

Any Current Bankruptcies?

YES
NO

Any Tax Liens?

YES
NO

Any Judgments?

YES
NO

Any Existing SBA Loans?

YES
NO

If yes, explain:

SECTION 7 — DOCUMENT CHECKLIST

SECTION 8 — AUTHORIZATION & CERTIFICATION

I hereby certify that the information provided in this application is true and complete to the best of my knowledge. I authorize Access Capital International and its lending partners to verify all information provided, including obtaining business and consumer credit reports where permitted by law. I understand that submission of this application does not guarantee approval or funding. TYPE YOUR FULL NAME

Date:

Access Capital International

COMMERCIAL LOAN APPLICATION: Fill this out, Now. Thank you

Please fill out completely

COMMERCIAL FINANCING APPLICATION

CONFIDENTIAL BUSINESS FUNDING REQUEST FORM