COMMERCIAL LOAN APPLICATION
FOR VENTURE CAPITAL, EQUIPMENT LEASING and BUSINESS LOANS

Business Details
Date:
Applicant's Name:
Street Address:
City:
Province:
Postal Code:
Home Phone:
Work Phone:
E-mail Address:
Best Time to Contact You:
When was business started?
What is business style?
If a Corporation - provide date of incorporation
If a Corporation - provide state/province of incorporation
????? Branch Subsidiary

Please list, with title, all Principals.

What products or services are provided by this business. Forward literature and pricing.

What are your marketing methods? Salesmen, distribution, etc. - please provide details.
Describe geographical areas serviced by this businesss.

Please describe the customers of this business.

Loan Details
Reason for Loan:
Loan Amount Desired:
Does your business have a
Dun & Bradstreet rating?		 Yes No
Rating:
Date of Rating:
(please forward copy fo Transmittal Memo)
Primary Bank Reference: Name

Branch

Address

Officer to contact

Telephone
Secondary Bank Reference: Name

Branch

Address

Officer to contact

Telephone
What services do these banks provide? Primary Bank

Secondary bank
Trade Reference 1 Name

Address

Contact

Telephone

Terms
Trade Reference 2 Name

Address

Contact

Telephone

Terms
Trade Reference 3 Name

Address

Contact

Telephone

Terms
What is your present finance source?
 Company Name

Address

Contact

Telephone

Description of Program

Rate

Reserve (if any)

Percent of Advance
Do you have an "In-House" Finance Plan? Yes No
If "Yes", is business entity and name
the same as Applicant?		 Yes No

Describe:
If Applicant is a Branch, Subsidiary, etc., do you
have a finance affiliation?		 Yes No

What are the details?