Application Cover Page Rev 4/2008 Applicant’s Name: (Please Print) __________________________________________
Credit History:
1. Applicant has been your customer for _____________ year(s). 2. Estimated loan amount used for dealer purchases $____________________ 3. Total sales to applicant in last fiscal year were $________________. 4. Applicant currently owes $___________ for inputs purchases from _________ to __________. Will this be applied to the loan? 5. Credit reputation in community: Yes No Good Average Poor
Excellent
6. Applicant has paid open accounts with you by paying the balance: When statement is due INPUT COST (Optional)
Crop Inputs Total Acres Fertilizer Cost Chemical Cost Seed Cost Fuel Cost Total Input Cost Total
End of the year
Never completely pays off account
Cash Only
Special Requests or Comments:
Dealer Buy Down -_______% Dealer Add-On +_______% (Subject to state law and your program contract.) If loan request is greater than $100,000 and any information Yes No is missing, should we contact the applicant directly?
I hereby certify that to the best of my knowledge, the information on the customer’s application, including loan request, and this Cover Sheet are true and accurate. _____________________________________________ Dealer Authorized Representative Signature Date _____________________________________________ Dealer Location (City and State) (______)___________________(______)____________ Dealer Phone Dealer Fax Please fax this cover page with application to 877-282-7861
Application Help Index Rev. 4/2008
WWW.THEPROPARTNERS.COM Phone (866) 822-7402 Fax (877) 282-7861
Please refer to web site for more details and forms or call for more information. Fax cover page, page 1, page 2 and any supplemental pages.
Types of Loans Available
1. 1st Priority Lien on crops: no max loan size, may require a lien on M&E, normally requires joint checks. 2. 2nd Priority Lien on crops: no max loan size, high quality credit, normally requires a Jr. Lien on M&E, requires list of buyers but no joint checks unless in default. 3. Junior Lien on crops: $200,000 max loan size, high quality credit, normally requires a Jr. Lien on M&E. 4. Unsecured (No Lien): $200,000 max loan size, high quality credit, balance sheet required on all loans, loan to net worth can not exceed 10%. 5. Grain Inventory 1st Priority Lien on crops: No max loan size, normally requires a Jr. Lien on M&E, requires joint checks.
Financial Information Requirements
1. Current balance sheet within 90 days with schedules if loan request is greater than $100,000 2. Last 3 years Tax Forms 1040 and Schedule F if loan request is greater than $250,000. 3. Two previous years balance sheet with schedules if loan request is greater than $500,000.
Types of Business Entities
1. Individual/Proprietorship: Provide applicant’s full legal name and social security number. 2. Partnership: Provide the following information with the application: • • • • • • • If the partnership is an informal partnership or a D/B/A, complete informal partnership agreement form available on our website. If the partnership is a formal partnership, provide a copy of the Partnership Agreement and amendments.
3. Corporation: Provide the following items with the application: A copy of the Articles of Incorporation & Amendments, if any. Completed Corporation Borrowing Authorization & Certification form available on our website.
4. Limited Liability Company: Provide the following items with the application: Articles of Organization (provided by applicant). Operating Agreement / Member Control Agreement (provided by applicant). Limited Liability Company Borrowing Authorization & Certification form available on our website.
Other: Trusts, Estates, etc.
Application Page 1 of 2 Rev 4/2008 FAX To: 877-282-7861
PLEASE PRINT CLEARLY IN INK
AMOUNT OF LOAN REQUEST: $___________________ or check box for maximum allowable LOAN TYPE REQUESTED:
Loan requiring: 1st Priority Lien
(Refer to help index on back)
2nd Priority Lien
Jr. Lien
No Lien-Unsecured
Grain Inventory 1st Priority Lien
APPLICANT’S TYPE OF BUSINESS:
Individual/Proprietorship
(Refer to help index)
Partnership
Corporation
Other _________________________
APPLICANT’S GENERAL INFORMATION
First Full Legal or Entity Name Middle Last Social Security or Tax ID Number Year Began Farming Date of Birth Marital Status
Code M = Married U = Unmarried S = Separated
Provide explanation if answered yes
Do you sell farm products under names not identified on this application? Are you involved in any other businesses, partnerships or corporations? Are any of the applicants an Employee or Director of the dealer?
Yes Yes Yes
No ____________________________________ No ____________________________________ No
Street Address____________________________________________ City, State Zip ____________________________________________ E-mail address ___________________________________________
Phone Number Cell Phone Number County of Residence
(______) __________________ (______) __________________ _________________________
APPLICANT’S CURRENT FINANCIAL INFORMATION
Gross Farm Income Non-Farm Income $_________________________ $_________________________ Total Assets $_________________________
Total Liabilities $_________________________
Who is your primary lender? ___________________________ Contact _______________________ Phone (_______) ___________________ Last year’s crop financed by ___________________________ Contact _______________________ Phone (_______) ___________________
Each of the undersigned specifically represents to lender and lender's agents, successors and assigns (Lender) that the information in this application is true and complete. Lender can verify the information in this application and any information I subsequently add, and provide any information requested by my creditors. My creditors and insurance agents are authorized to provide all relevant information to Lender. Lender and my creditors are released from all claims for omissions which occur in verifying the above information. The dealer is not authorized to extend commitments for financing or any terms thereof, including interest rate, and no discussion with dealer may be construed as a commitment for financing. Lender is not responsible for any representation guarantee, or warranty made by the dealer, manufacturer or any other party in connection with the item(s) financed, nor shall Lender be liable for any breach of such warranties. Lender has permission to obtain a credit report for legitimate purposes in connection with this transaction, including making a credit decision, monitoring and collecting the account. Lender may share its credit decision and credit experience with the dealer and disburse loan proceeds directly to the dealer for the purpose requested in the application. Where there is more than one signature below, it is the intent of all to apply for joint credit. Ohio ECOA: The Ohio laws against discrimination require that all creditors make credit equally available to all creditworthy customers and that credit reporting agencies maintain separate credit histories on each individual request. The Ohio civil rights commission administers compliance with this law. The information contained in this application is provided for the purpose of obtaining business (non-consumer) credit with the Lender on behalf of the undersigned. To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify and record information that identifies each person who applies for a loan. So in addition to the information requested herein, we may also ask to see your driver’s license or other identifying documents.
____________________________________________________ Applicant Signature Date
_______________________________________________________ Co Applicant Signature Date
Application Page 2 of 2 Rev. 4/2008 Applicant’s Name: (Please Print)_________________________________________________ CROP PLANNING INFORMATION
Crop Acres Proven or FSA Yield Total Production (Less) Prod. Used for Feed (Less) Landlord’s Share Net Production Insurance coverage: MPCI, CRC, etc. Type % Target Price Total Crop Value
Total crop value:
CROP INSURANCE
Yes
No
Crop Ins. Agent ____________________________________________ Ins. Agent Phone Number (_______) ________________________ Ins. Agent Address________________________________________________________________________________________________
LIST OF BUYERS
Name Address City and State Phone
LOCATION OF ACRES (GA, LA & MS States must complete Full Legal Description page)
County/Parish State
FSA INFORMATION
County and State FSA payments are received from List all applicants receiving payments in this county.
LIVESTOCK
Gross Income from Livestock Total Monthly Livestock Assignments to Lenders
DAIRY
Gross Income from Dairy Total Monthly Dairy Assignments to Lenders
Custom feeder:
# of head
Yes
No
Type of livestock
Average pounds of Milk/Cow/Year
Average Milk Producing Cows in herd Milk Sold to
Name Address Phone #
Full Legal Description Page Rev. 4/2008 Applicant’s Name: (Please Print)_________________________________________________ LEGAL DESCRIPTION Louisiana and Mississippi – complete all fields
Crop Quarter
(ex. - NW 1/4, SW 1/4)
Section No.
Twp. No.
N or S
Range No.
E or W
Farm No.
Legal Owner of Record
County/Parish
State
LEGAL DESCRIPTION Georgia - complete all fields
Crop Land Lot # District # Farm No. Legal Owner of Record County/Parish State
Grain Inventory Application Additional Information Rev. 4/2008 Applicant’s Name: (Please Print)_________________________________________________ ELEVATOR STORAGE
Warehouse Receipt Number Type of Grain Bushels
ON FARM STORAGE
Type of Grain Diameter of Bin # of Rings Filled Bushel Capacity per Ring Estimated Stored Bushels Common Property Description
Please note, a 10% error margin will be utilized in calculating the gross bushels available for loan consideration.
Commodity Credit Corporation Measurement Option: Loan applicant may elect to have CCC measure the grain stored on farm. If this is the case, then the elevator needs only to attach a copy of the measurement sheet to certify the grain bushels held in storage. Under this option, no 10% error reduction will apply. Also, if the loan applicant elects to exercise this option, said applicant is responsible for the measurement fees charged by CCC. MARKETING PLAN Forward Contracted (Complete Table & Attach Copy of all Contracts)
Commodity Bushels Contract Price
Open Market
Delivery Date
$ $ $
$ $ $ $