New Business Loan Application
Your Name:Contact Number:
E-mail Address:
Full address including city, state, zip & county:
How long have you lived at this address?
Address Type:
How much you pay per month in rent or mortgage?
Marital Status:
Date of Birth:
Social Security Number:
Requested Loan Amount:
Business use for the Proceeds: (Provide full details):
Business Name:
Contact Number:
Full address including your city, state & zip:
Business Entity Type:
Tax ID Number:
Business Start Date:
Storefront Details:
State of Incorporation:
Website:
What industry is the business in? (describe in detail what the business does):
List all Owners and percentage of ownership: (Must equals to 100%):
Does the business currently have any merchant cash advances or any other outstanding loans? If yes: 1. What was the original funding amount? 2: What is the current payoff balance?
Type of account you have for your business:
What is the business average bank balance?
What is the business monthly deposits?
Has the business accepted credit cards for at least 3 months?
What is the business monthly credit card volume?
How many employees does the business have?
Do you pay yourself a salary from the business each month?
If yes, how much per month?
Total monthly income for current month:
Total monthly income for previous month 1:
Total monthly income for previous month 2:
Total monthly income for previous month 3:
What is your total monthly personal expenses? (excluding housing expense):
What is the value of your personal cash balances?
What is the value of your personal retirement balances?
What is the value of your publicly traded stock?
Has your loan request been turned down before?
If yes, reason for Turn Down?
Do you or any of the Owners have back taxes or liens, judgments, bankruptcies, foreclosures, late payments, collections, criminal convictions, open lawsuits or other significant derogatory accounts? If yes, explain in detail:
Exit Strategy: (In detail & at least 4 paragraphs):
There will be a one-time Tri-Merge Credit Report fee of $45 & an Invoice will be e-mailed to you. Do you understand?
Enter the name of the person that sent you to this site to place your file as "Priority".