Business Profile – Business Tax ID #:	Is Required
Bus Established (mo/yr):	Select January February March April May June July August September October November December / 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027	Owner Since (mo/yr):	Select January February March April May June July August September October November December / 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027
No. of Employees:	Is required	Work E-mail:	Enter valid email address
Existing Bank Relationship – Bank Name(s):	Is Required
No. of Checking Accts:	Is Required	Total Avg. Balances in Checking:
No. of Savings Accts:	Is Required	Total Avg. Balances in Savings:	Is Required
Existing Balances on Business Lines of Credit:	Is Required
Existing Balances of Business Credit Cards:	Is Required
Existing Balances of Business Loans / Equip. Financing / Leases:	Is Required
Business Category (i.e. what does business do):	Is Required
Has the business had any bankruptcies or judgments filed against it?	Yes No
Purpose of Loan / Line of Credit (i.e. working capital):	Is Required

Business Financials – Most Recent Fiscal Year End
Is your current fiscal year end December 31?	Yes No
Annual Sales:	Is Required	Net Income After Taxes:	Is Required
Total Current Monthly Business Debt Payment:			Is Required
Annual Interest Expense:	Is Required
Annual Interest Expense: Approx. amt. of interest paid on bus loans, lines of credit, and credit cards throughout year)
Annual Depreciation Expense:	Is Required
(Approx. reduction in the value of the business’ property, building, and equipment over one year)
Current Liabilities:	Is Required
(Approx. amt. owed on all obligations – incl. debts, taxes, other – that require payment within coming year)
Total Debt:	Is Required
(Approx. amt. owed on all obligations, regardless of when they are due)

Business Assets / Collateral– accts. receivable, inventory, & equipment owned can be used to “secure” the loan / line of credit by “all business assets”, which allows for priority pricing
Current Value of: Do you wish to pledge the following collateral			Yes No
Accts. Receivable:	Is Required	Inventory:	Is Required	Equip Owned:	Is Required

Business Owner / Guarantor – Personal Net Worth: $
Personal Income: (incl. salary from business)	Is Required	Monthly Housing Payment:	Is Required