Business Loan Application

Name *

First Name

Last Name

Business Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Type of Business *

Sole Proprietorship

Partnership

Corporation

LLC

Other

Select all that apply: What is the purpose of the loan? *

Working Capital

Equipment Purchase

Inventory Purchase

Real Estate Purchase

Debt Consolidation

Buying a Business

Selling a Business

Buying out a Partner

Buying into a Business

Other

Preferred Loan Term *

Short-term (1-3 years)

Medium-term (3-5 years)

Long-term (5+ years)