Loan Application
Section 1: Business Information Business Owner(s): Your Name (required)
Social Security Number
Address
City
State
Zip
Birth Date
Your Name
Business Phone
Home Phone
Mobile Phone
Your Email (required)
Legal Business Name
Doing Business As
Business Address
Describe Your Product or Business
Business Status new (under 12 months)existing (over 12 months)
Date Business Was Established
Number of Employees (including owner(s))
Full Time
Part Time
Have you met all the legal requirements necessary to establish your business? yesnonotsure
Federal Tax ID Number (if you have one)
Type of Business Organization partnerships corporationsole Proprietorshipc corporationnot yet establishedother
Is Your Business For Profit? yesno
Section 2: Business Plan Information
Have You Completed a Business Plan yesno
When and by whom was the Business Plan prepared?
If you have not completed a Business Plan, would you like assistance in preparing one? yesno
Section 3: Financing Information
Purpose of Loan Request
Have You Applied for Other Lending yesno
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 months
Proposed collateral: Business AssetsMortgageCo-SignerOther
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.