South Shore Bank
Welcome to South Shore Bank > E-Branch > Online Applications > Small Business Loan Application

Business Financing Statement

Credit Request for $10,000 to $500,000 (Total Commercial Exposure)

Product Type:
Stream Line of Credit
(up to $50,000 total exposure)
Business Line of Credit
Business Cash Reserve
Product Type:   Interest Rate:   # Months
Stream Term Loan
(up to $100,000 total exposure)
    1 to 60    months
Business Term Loan     1 to 60    months
Commercial Real Estate Loan     Up to 25 Years  
 years    months
Loan Guaranteed by SBA     1 to 84    months
Purpose:  Amount Requested: $

Business Information

Business Name:  Tax ID #: 
Street Address: 
City:  State:  Zip: 
E-Mail Address: 
Phone #: ()- Fax #: ()-
Please check one
 Regular Corporation  Sole Proprietorship  Non-Profit Organization
 Limited Liability Corp.  Partnership  S Corporation
 Other (Explain)  
 
Other Legal Status Explanation: 

Type of Business
 Manufacturer  Retailer  Wholesaler/Distributor
 Service Company  Other (Specify)  
 
Other Business Type Explanation: 

Year Established:  Describe Nature of Business: 
 
# of Employees:  NICS Code: 

Primary Bank Business Relationship:  Total Cash in Business Account: $ Annual Net Sales: $
Total Business Debt: $ Monthly Debt: $
Net Cash Flow (Profit + Interest + Depreciation): $

Schedule of Business Assets

  Original Value Current Value Loan Balance Lendor/Lessor
Accounts Receivable $ $ $ $
Inventory $ $ $ $
Furniture & Fixtures $ $ $ $
Machinery & Equipment $ $ $ $
Land & Buildings $ $ $ $

Ownership Information

Name:  Ownership Type: 
Title:  Home Phone: ()-
Address: 
City: 
State:  Zip: 
Social Security Number:
--
Date of Birth:
 /  / 
Years at Firm:  Percentage Owned: 
Drivers License # and State:
Total Personal Cash: $ Total Household Income: $
Value of Primary Residence: 
$
Mortgage Owed on Primary Residence: 
$
Total Assets: $ Total Liabilities: $
Total Monthly Mortgage or Rent: $ Type: 
Monthly Term Payments: 
$
Monthly Revolving Payment: 
$
Name:  Ownership Type: 
Title:  Home Phone: ()-
Address: 
City: 
State:  Zip: 
Social Security Number:
--
Date of Birth:
 /  / 
Years at Firm:  Percentage Owned: 
Drivers License # and State:
Total Personal Cash: $ Total Household Income: $
Value of Primary Residence: 
$
Mortgage Owed on Primary Residence: 
$
Total Assets: $ Total Liabilities: $
Total Monthly Mortgage or Rent: $ Type: 
Monthly Term Payments: 
$
Monthly Revolving Payment: 
$

Personal Financial Statement

Assets   Liabilities  
Cash $ Bank Loans $

Marketable Securities $ Consumer Debt $

Real Estate $ Mortgages on Real Estate $

Cash Surrender Value $ Loans Against Securities $

Other Assets $ Loans Against Life Insurance $

Other Investments $ Other Liabilities $
Total Assets $ Borrowings Against Investment $
    Total Liabilities $
  Net Worth (Total Assets - Total Liabilities) $
Please answer the following questions. Please enter 0 if there is no value for a particular amount.
Are you a guarantor, co-maker, or endorser for any debt of an individual,
corporation or partnership?
Yes No
Amount $
Do you have any outstanding letters of credit or surety bonds?
Yes No
Amount $
Are there any suits or legal actions pending?
Yes No
Amount $
Are any of your tax obligations past due?
Yes No
Amount $
What is the amount of insurance coverage in your business assets? Amount $
If your debt is being refinanced, was the original loan through the SBA?
Yes No N/A
Amount $
Have either of you or any firm in which you were a major owner ever declared
bankruptcy?
Yes No
 
Has the business had a loss in the past 3 years?
Yes No
Amount $
Is the business for sale or under an agreement that would change the ownership of
the business?
Yes No
If you answered yes to the last question, please explain.

Representations and Warranties
The information contained in this statement is provided to induce you to extend or to continue the extension of credit to the undersigned or to others upon the guarantee of the undersigned. The undersigned acknowledge and understand that you are relying on the information provided herein in deciding to grant or continue credit or to accept a guarantee thereof. Each of the undersigned represents, warrants and certifies that the information provided herein is true, correct and complete. Each of the undersigned agrees to notify you immediately and in writing of any change in name, address or employment and of any material adverse change (1) in any of the information contained in this statement or (2) in the financial condition of any of the undersigned or (3) in the ability of any of the undersigned to perform its (or their) obligations to you. In the absence of such notice or a new and full written statement, this should be considered as a continuing statement and substantially correct. If the undersigned fail to notify you as required above, or if any of the information herein should prove to be inaccurate or incomplete in any material respect, you may declare the indebtedness of the undersigned or the indebtedness guaranteed by the undersigned, as the case may be, immediately due and payable. You are authorized to make all inquiries you deem necessary to verify the accuracy of the information contained herein and to determine the credit-worthiness of the undersigned. The undersigned authorize any person or consumer reporting agency to give you any information it may have on the undersigned. Each of the undersigned authorizes you to answer questions about your credit experience with the undersigned. This personal financial statement and any other financial or other information that the undersigned give you shall be your property.

 


Powered by novo