Brock C. Salazar

Owner Broker

SBA/Business Loan Application

First Name *

Last Name *

Date of birth

Phone *

Email *

Address *

City *

Postal code *

State *

Do you Rent or Own? *

Prior address if less than 2 years. *

How much is your montly housing payment? *

How long have you lived at this address? *

Social Secuirty Number: (We must pull your credit.) *

Social security card borrower / guarantor

Drivers License Number *

State Drivers License Upload

State Driver's License Upload

Credit Score *

Upload Your Credit Scores

Upload Credit Report here or copy of scores

Upload Free Credit Report Here for prequal

Legal Business Name: *

Full business address including City, State & Zip: *

Legal Entity: (Corp, LLC, Sole Prop, etc) *

Signed Articles of Incorporation

Articles of Incorporation

Business Phone:

Business Email:

Business classification: (Retail, Restaurant, Services, Internet, Mail Order, etc) *

Company Owner Name *

Percentage of Business Ownership: *

Business Established Date:

Ownership Date if different from Business Start Date

Signed Operating Agreement

EIN *

EIN Letter Upload Here

Do you have outstanding business debt? *

If yes, what is the balance and held with what lender? *

Upload Business Credit/Line of Credit Payoff

Number of Employees

Do you pay yourself a salary form the business (W2)? If yes,How Much per Month?

Do you currently have a Loan/Advance Balance? *

Total monthly sales: *

Use of Funds: *

List 3 Trade References here: (Company name, Contact name & phone number or email address) *

Business Website *

Property Ownership: Lease or Own?

Date your lease started or date ownership started:

Landlord information if lease. Lender information if own: (Name, contact number, email & address)

Business rent or mortgage:

Has the business or any principal ever filed bankruptcy? *

buz-bk?

Borrower Signature *

Clear

Borrower/Guarantor Signature

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