Unsecured Business Line of Credit Application for Corporations

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					                  Unsecured Business Line of Credit Application for Corporations
                       (Please print and fill out the information, then FAX it to the number below)
                                         FAX: (765)319-2397 Telephone: (901) 359-2397
               Make more copies if more than 1 borrower; i.e. spouse, partners etc.
                Please be accurate on all items. Lender may require verification.
PERSONAL INFORMATION                                            BUSINESS INFORMATION
First Name:                                                     Business Legal Name:
Last Name:                                                      Business address:
Home Address:                                                   City/State/Zip
City/State/Zip Code:                                            County:
Social Security #                                               Bus Telephone:
Email:                                                          Bus Fax:
Home Ph:                                                        Tax id (EIN#)
Cell Ph:                                                        Business Industry:
                                                                Date/State of Incorporate:
Birth Date:                                                     Date operations began:
Housing: Own/Rent Years at address:                             Date/State of Incorporate:
Primary Residence Value: $                                      Yr Current management began:
Amount owed on Primary Res: $
Monthly House Pmt:$                                             Outstanding Bus Loans: $
Personal Middle FICO Score:                                     Net Income last FYE:(Line 1A form 1120):$
Experian FICO Score (if known):                                 Adjusted Gross income(line 37 form 1120):$
Personal income (Line 7 of IRS 1040):$                          Taxable income(line 43):$
Adjusted Gross income(line 37):$
Mother’s Maiden Name:

DL# State                                                       Total Assets in LLC: $
License issue date                                              Current Liabilities: $
Exp date                                                        Long Term Liabilities:$
Liquid Assets:$                                                 Liquid Assets: $
Retirement assets:$                                             Number of Employees:
Real estate owned: $                                            Depreciation expense: (Form 1120 line 40):$
Amount owed:$
Bank Relationships                                              Bank Relationships:
Balance in Bank:$                                               Balance in Bank:
2nd Bank:                                                       Bank #2 If any.
Balance in bank:$                                               Balance in bank:$

Nearest relative not living with you:                           Business Description: What do you do?
With telephone

LLC/Corp. Ownership breakdown percentage:
List other owners with percentage ownership:
SIGNATURE                                                       DATE