Microenterprise Loan Application Form
Confidential Name of Applicant:__________________________ Social Security #_____-____-_____ Home Address:___________________________________________________________ Name of Business:________________________________________________________ Address of Business: ___________________________________________________ Phone______________________________ Fax_________________________ Email:____________________________________________ Principal Owner/Operator: _________________________________
Banking Information: Primary Bank __________________________________ Savings Account? Yes ____ No_____ Checking Account? Yes____ No_____
Loan Amount Requested: $__________________
Loan is to be used for: ___ Capital Equipment ___ Inventory ___ Marketing / Advertising ___ Rent / Lease ___ Training ___ Other. Please specify__________________
Requirements for Loan Repayment: A loan in the amount of $1000-$1500 must be repaid within one year. Payments to be made to the WOLCDC on a monthly basis. (Amount borrowed, divided by 12 = payment amount). A loan in the amount exceeding $1500 can be repaid within a two-year period, with payments made to the WOLCDC on a monthly basis. (Amount borrowed divided by 24 = payment amount). Maximum loan amount is not to exceed $4,000.
Application Fee: The application fee is $50 per $1000 borrowed per year, pro-rated. (example: $1800 loan for one year = $ 90…… $2500 loan for two years = $250) Full Application Fee is due at time of application: Amount Due: $__________ If the loan is denied, your application fee will be returned to you. Please note that if your loan is approved, and you choose not to go ahead with it, your application fee is nonrefundable. Credit Check Fee: $10 per application. This is a non-refundable expenditure. Applicant’s Full Name (first/middle/last):________________________________ Applicant’s Social Security Number:____________________________________ Loan Application Time Frame: It will take approximately three to five weeks from application receipt to receive determination on the loan request. If approved, the money will be available within two weeks.
I verify that I have authorized the WOLCDC to perform a credit check on my name: ________(initial) I verify that I have a DBA _______ (initial)…or… Incorporated __________ (initial) I verify that I have met all required local and state regulations and operate with all required permits: __________ (initial) _____The Business Plan Worksheet is attached. I accept the conditions of this application, and verify that all of the information provided is accurate. _____________________________________ Signature _____________ Date
Amount collected from the applicant $___________________
___________________________ Signature of WOLCDC Director
_________________ Date
The loan program complies with all local, state and national laws, thereby protecting the applicant against bias based on race, religion, gender, sexual identity, color, national origin, or handicap.
The Process for Applying for a Microenterprise Loan from the Western Ontario Local Community Development Corporation
1. Pick up an application and business plan worksheet from the WOLCDC. 2. Fill out both forms completely and arrange for a meeting time with the WOLCDC Director to review the application. 3. Pay the application fee and credit check fee to the WOLCDC. 4. A. Within approximately three to five weeks, the loan board will review the application and vote to approve or deny the loan request. B. The applicant must attend the loan board review meeting to present his or her application. C. If the loan request is denied, the application fee will be reimbursed to the applicant. 5. If the loan is approved and the applicant decides not to accept the money, the application fee is non-refundable. 6. Regardless of loan approval or denial, the credit check fee of $10 is non-refundable. 7. If the loan is approved, the applicant will receive the loan money within two weeks. 8. At the time of receipt of the loan money, the applicant will sign a promissory note to the WOLCDC for repayment of the loan. 9. The loan will be repaid in monthly installments (interest free). Payment will be made directly to the Village of Bloomfield clerk at the Village Hall address by the first of each month. A late fee of 2% will be charged if payment is not received by the 7th of the month.
The loan fund is in a Trust in Agency Account. Checks are to be made payable to: WOLCDC Loan Program, 12 Main Street, Bloomfield, NY 14469.