Section 1: Business Information
Your Name (required)
Social Security Number
Your Email (required)
Legal Business Name
Doing Business As
Describe Your Product or Business
new (under 12 months)existing (over 12 months)
Date Business Was Established
Number of Employees (including owner(s))
Have you met all the legal requirements necessary to establish your business?
Federal Tax ID Number (if you have one)
Type of Business Organization
partnerships corporationsole Proprietorshipc corporationnot yet establishedother
Is Your Business For Profit?
Section 2: Business Plan Information
Have You Completed a Business Plan
When and by whom was the Business Plan prepared?
If you have not completed a Business Plan, would you like assistance in preparing one?
Section 3: Financing Information
Purpose of Loan Request
Have You Applied for Other Lending
If yes from whom?
Type of Funding
What is the status of your application?
How did you hear about UDBDA?
Total amount of loan request:
I would like to pay off the loan in
Amount and source of personal (non-loan) funds that you have invested or plan to invest in the business/project:
Source (savings, credit card, personal loan, other)
Please send a $100 application fee made payable “Fay-Penn Economic Development Council. Application will not be processed until payment is received.