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Starting a Business: Loan Intake Form


A major obstacle to starting your own business is obtaining financing. The loan process can be significantly simplified if you take a proactive approach: locate and make copies of relevant documents prior to meeting with you finance officer or bank. Below is a list of information you should be ready to provide your finance officer or bank upon your initial visit.

Company:

Name: ____________________ Phone: ____________________

Address: ____________________ Fax: ____________________

City/State/Zip: ____________________ E-Mail: ____________________

Other Locations:

 

Address: ____________________ Address: ____________________

City/State/Zip: ____________________ City/State/Zip: ____________________

Type of Entity:

 

Sole Proprietorship? _____

Partnership? _____

Corporation? _____

Limited Liability Co.? _____

Other? _____

Company Information:

 

Date started business: __________

Number of partners: __________

(If partnership)

Number of shareholders: __________

(If corporation)

Number of members: __________

(If LLC)

Trade or Assumed Name: __________

Federal Tax I.D. No.: __________

State Tax I.D. No. __________

Company Management:

 

Name: ____________________ Name: ____________________

Title: ____________________ Title: ____________________

Address: ____________________ Address: ____________________

City/State/Zip: ____________________ City/State/Zip: ____________________

Ownership Interest:________________ Ownership Interest:________________

Name: ____________________ Name: ____________________

Title: ____________________ Title: ____________________

Address: ____________________ Address: ____________________

City/State/Zip: ____________________ City/State/Zip: ____________________

Ownership Interest:________________ Ownership Interest:________________

Banking Relationships:

Bank 1

Name: ____________________

Address: ____________________

City/State/Zip: ____________________

Checking? _____

Savings? _____

Lockbox? _____

Other? _____

Loan 1:

Amount: $___________________

Due Date: ____________________

Collateral: ____________________

Guarantor: ____________________

Loan 2:

Amount: $___________________

Due Date: ____________________

Collateral: ____________________

Guarantor: ____________________

Bank 2

Bank: ____________________

Address: ____________________

City/State/Zip: ____________________

Checking? _____

Savings? _____

Lockbox? _____

Other? _____

Loan 1

Amount: $___________________

Due Date: ____________________

Collateral: ____________________

Guarantor: ____________________

Loan 2

Amount: $___________________

Due Date: ____________________

Collateral: ____________________

Guarantor: ____________________

Accountant:

Name: ____________________

Company" ____________________

Address: ____________________

City/State/Zip: ____________________


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