Small Business Loan Application Checklist by osq14347

VIEWS: 28 PAGES: 18

									                                                                                                            20175 N 67th Avenue
                                                                                                              Glendale,AZ 85308
                                                                                                                 (602) 508-3701

                                       Small Business Loan Application Checklist
Business Information
q Business Loan Application (form enclosed).
q Year End Financial Statements for the last three years, if applicable.
q Interim Financial Statement not more than 60 days old.
q Form 4506-T (so we can verify the business tax returns - form enclosed).
q_ Aging_of_Accounts_Receivable_dated_the_same_date_as_the_interim_financial_statements.
q_ Aging_of_Accounts_Payable_dated_the_same_date_as_the_interim_financial_statements.
q Business Debt Schedule (form enclosed - must reconcile to interim business balance sheet).
q Business Federal Income Tax Returns for the past three years including all schedules.
q Business History (form enclosed).

Personal Information (required for any principal owner with 20% or more ownership interest):
q Personal Federal Income Tax Returns for the past three years, including all K-1s & schedules.
q Personal Financial Statement not more than 60 days old (form enclosed).
q Resume
q_ Statement_of_Personal_History_(officers_&_owners_of_20%_or_more_of_the_business_-_form_enclosed).
q Form 4506 –T (so we can verify the personal tax returns - form enclosed).

Legal Information:
q_ If_Limited_Liability_Corporation:_Articles_of_Organization_(filed_copy)_and_Operating_Agreement.
q_ If_Corporation:_Articles_of_Incorporation_(filed_copy)_and_Bylaws.
q If Partnership: Partnership Agreement.
q If Trust: Trust Agreement.

For Real Estate Construction / Acquisition / Leased Site:
q Construction Cost Breakdown or Tenant Improvement Cost Breakdown, where applicable.
q Executed Purchase Agreement.
q Evidence of down payment.
q Existing or Proposed Building Leases(s) (if applicable).
q Site History Form (form enclosed).

For Debt Refinance:
q Copy of Note(s) to be paid off with requested loan proceeds.

For Business Acquisition:
q Copy of the Purchase Agreement. (include an allocation of business assets being purchased)
q Buyer’s Business Plan
q_ Projected_Operating_Statement_for_next_2_fiscal_years,_Projections_should_be_prepared_on_a_monthly_basis_showing_income_and_
   expenses.

Affiliate Information:
q Corporate Federal Income Tax Returns for the past three years including all schedules.
q Business Debt Schedule.

For Hospitality Financing:
q Smith Travel summary (if available).
q Average Daily Rate and average Daily Occupancy monthly for the past three years.
q Copy of Most Recent Quality Assurance Report.
q Copy of Franchise Agreement.

BNC National Bank                                                1                                    Small Business Loan Application
                                          20175 N 67th Avenue
                                          Glendale, AZ 85308
                                                                                                                       Small Business
                                          (602) 508-3701                                                             Loan Application
                                                                    General Information
Company Name:_____________________________________________                                       Phone: (_____)__________________________________
Street Address/City/State/Zip: __________________________________________________________________________________
Mailing Address/City/State/Zip: _________________________________________________________________________________
Type of Business:_______________ Date Established:______________ Tax I.D. or SSN: _________________________________
Number of Employees Existing:__________________ Employees Projected: ____________________________________________

Type of Entity: q Corporation q Partnership q Sole Proprietorship q Limited Liability Company
                q Limited Liability Partnership q Other: ___________________________________________________________
Key Contact Name: _______________________________________________________ Phone: (_____) _____________________
Key Contact Name: _______________________________________________________                                            Phone: (_____) _____________________
Accountant Name: _______________________________________________________                                             Phone: (_____) _____________________
Attorney Name:__________________________________________________________                                             Phone: (_____) _____________________
Insurance Agent: _________________________________________________________                                           Phone: (_____) _____________________



                                                         Ownership of Applicant Company
   List_all_officers,_directors,_partners,_owners_and_co-owners_by_title_(i.e. President, Managing Partner, General Partner, Secretary,
                        Member, Manager, etc. and all other owners or partners. 100% of owners must be identified)
   ________________________Name_                              _____Title_                            %_of_Ownership_                    Annual_Compensation




Has there been any change in ownership of the operating entity within the last six months? q Yes q No


Declarations of Principal Owners, Officers, Directors (If yes, furnish details on a separate page)
1. Are any involved in any claim or lawsuit?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . q Yes q No
2.__Are_any_federal,_state,_or_local_taxes_delinquent?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . q Yes q No
3. Are any liable under contingency or guarantor agreements? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . q Yes q No
4. Have any ever been involved in bankruptcy or insolvency proceedings? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . q Yes q No
5. Do you have outstanding judgments? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . q Yes q No
6. Have any ever had property foreclosed upon or given title in lieu of foreclosure? . . . . . . . . . . . . . . . . . . . . . . . . . . . q Yes q No
7. Are any payments delinquent for child support? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . q Yes q No
8. Do you or any owner of this business have interest in any other business as an owner, principal or manager? . . . . . q Yes q No


BNC National Bank                                                                    2                                           Small Business Loan Application
Business Loan Application (cont)
                                                               Affiliates
Does the applicant company or any individual listed in the ownership section above have any ownership interest in or control of any
other company? q Yes q No If yes, please identify below
      Company Name                         Owner (Applicant Entity or Individuals)            % of Ownership             # of Employees




Purpose of Loan (More than one category may apply)
q Business Acquisition $______________________________
                                                                                               Estimated Financing Requirements
q Business Expansion $______________________________
                                                                                               1. Total Estimated Project Amount
q Commercial
                                                                                                  $ ___________________________
  Real Estate Purchase $______________________________
q Construction                                                                                 2._Less:
  Has construction or excavation already begun?                                                   a. Down Payment $ ______________
	 q Yes q No               $______________________________                                           (Source:_____________________
q Equipment Purchase $______________________________                                                 i.e., sale of assets, cash gifts, etc.)
q Working Capital          $______________________________                                        b. Other Financing $ _____________
q Line of Credit           $______________________________                                           (Source:_____________________
q Inventory Purchase       $______________________________                                           i.e., seller carry-back, leases, etc.)
q Standby Letter of Credit $______________________________                                     3. Loan Amount Requested
                                                                                               _ (Line_1_minus_Lines_2a/2b)
Term of Loan Requested _________ Years                                                              $ ___________________________

For Commercial Real Estate Purchase: How do you wish to take title?
q Individual q Joint Tenant q Corporation q Partnership q Other _______________________________________________

_____________________________________              _____________________         ______________
  Signature                                         Title                          Date


_____________________________________              _____________________         ______________
  Signature                                         Title                          Date



                                      Procedures For Opening A New Account
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_opens_an_account._

What this means for you:
When you open an account, we will ask you for your name, address, date of birth, and other information that will allow us to identify
you. We may also ask to see your driver’s license or other identifying documents.




                                                     Disclosure Statement
Borrowers of BNC National Bank are not required to obtain insurance from a particular insurance company. Any insurance required
as a condition of the extension of credit by BNC National Bank may without affecting approval of the application for an extension of
credit, be purchased from an insurance company of the Borrower’s choice.



BNC National Bank                                                   3                                  Small Business Loan Application
                                           Equal Credit Opportunity Act Notice
The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color,
religion, national origin, sex, marital status, age (provided that the applicant has the capacity to enter into a binding contract), because
all or part of the applicant’s income derives from any public assistance program, or because the applicant has in good faith exercised
any right under the Consumer Credit Protection Act. The federal agency that administers compliance with this law concerning the
Department_of_Housing_and_Urban_Development_is_the_Federal_Trade_Commission,_Equal_Credit_Opportunity,_Washington,_D.C._20580._
BNC_National_Bank_is_regulated_by_the_Comptroller_of_the_Currency,_2345_Grand_Ave.,_Suite_700,_Kansas_City,_MO_64108.

I/We represent that this application is complete and accurate. I/We authorize Lender to obtain a credit report and any other information
it deems necessary about my /our credit worthiness. I/We agree to notify Lender immediately, in writing, of any adverse change in my/
our_financial_condition._I/We_understand_that_Lender_will_retain_this_Application_whether_or_not_it_is_approved._

Lender_may_share_information_about_you_with_other_organizations_that_are_its_affiliates_unless_you_direct_Lender_not_to_do_so._If_you_do_
not_want_Lender_to_share_such_information_with_its_affiliates,_please_initial_here_________________._

BORROWER
_________________________________                 _____________________________________                ______________       ______________
 Company                                             Signature                                            Title               Date

                                                  _____________________________________                ______________       ______________
                                                     Signature                                            Title               Date

GuARANtORS
_________________________________                 _____________________________________                 ______________
 Printed Name                                        Signature                                            Date

_________________________________                 _____________________________________                 ______________
 Printed Name                                        Signature                                            Date



                                                       Credit Release Form
Each person signing below agrees as follows:

I, as an individual, even when a title follows my signature, and on behalf of the business making this application (the “Business”) hereby
authorize the release to BNC National Bank all information required or obtained by BNC National Bank for the purpose of reviewing the
Business on an ongoing basis. I also authorize BNC National Bank to release the business credit information to and otherwise exchange
information regarding the Business credit transactions with various business professionals involved in the business portion of the
transaction, including, but not limited to, commercial real estate brokers, real estate agents, accountants and attorneys, as well as any other
entity BNC National Bank deems necessary for any reason related to the Business credit transaction.

I hereby declare that the information I have provided BNC National Bank for the evaluation and processing of the Business credit
transaction, including the information described in exhibits or attachments, is true and correct, to the best of my knowledge.

I hereby acknowledge that loan approvals may be in writing and will likely be subject to terms and conditions possibly set forth
in_a_commitment_letter_signed_by_an_officer_of_BNC_National_Bank._By_signing_below,_each_person_signing_for_the_Business_and_
each person who is going to give BNC National Bank a guaranty of the Business for this credit transaction agrees to each of the
following: BNC National Bank is authorized now and in the future to obtain credit bureau reports and check the credit history of the
Business, each person who signs for the Business or is going to give BNC National Bank a guaranty of the Business; to the best of
your_knowledge_and_belief,_all_answers_to_the_questions_and_all_information_in_this_application,_together_with_the_financial_statements_
and other supporting documents are complete and true; BNC National Bank has the right to verify the accuracy of the information
provided in this application; and credit requested will be used for business purposes.

Agreed and acknowledged,

_____________________________________                _____________________          ______________
 Signature                                           Title                            Date


_____________________________________                _____________________          ______________
 Signature                                           Title                            Date


BNC National Bank                                                      4                                  Small Business Loan Application
Form    4506-T                             
                                                   Request for Transcript of Tax Return
                                             Do not sign this form unless all applicable lines have been completed.
                                                               Read the instructions on page 2.                                             OMB No. 1545-1872
(Rev. January 2008)
Department of the Treasury
                                          Request may be rejected if the form is incomplete, illegible, or any required
Internal Revenue Service                                   line was blank at the time of signature.
Tip: Use Form 4506-T to order a transcript or other return information free of charge. See the product list below. You can also call 1-800-829-1040 to
order a transcript. If you need a copy of your return, use Form 4506, Request for Copy of Tax Return. There is a fee to get a copy of your return.
 1a Name shown on tax return. If a joint return, enter the name shown first.                        1b First social security number on tax return or
                                                                                                       employer identification number (see instructions)


 2a If a joint return, enter spouse’s name shown on tax return                                      2b Second social security number if joint tax return



 3      Current name, address (including apt., room, or suite no.), city, state, and ZIP code



 4      Previous address shown on the last return filed if different from line 3



 5      If the transcript or tax information is to be mailed to a third party (such as a mortgage company), enter the third party’s name, address,
        and telephone number. The IRS has no control over what the third party does with the tax information.




Caution: DO NOT SIGN this form if a third party requires you to complete Form 4506-T, and lines 6 and 9 are blank.
 6      Transcript requested. Enter the tax form number here (1040, 1065, 1120, etc.) and check the appropriate box below. Enter only one tax
        form number per request. 
     a Return Transcript, which includes most of the line items of a tax return as filed with the IRS. Transcripts are only available for
        the following returns: Form 1040 series, Form 1065, Form 1120, Form 1120A, Form 1120H, Form 1120L, and Form 1120S.
        Return transcripts are available for the current year and returns processed during the prior 3 processing years. Most requests
        will be processed within 10 business days

     b Account Transcript, which contains information on the financial status of the account, such as payments made on the account, penalty
       assessments, and adjustments made by you or the IRS after the return was filed. Return information is limited to items such as tax liability
       and estimated tax payments. Account transcripts are available for most returns. Most requests will be processed within 30 calendar days
     c Record of Account, which is a combination of line item information and later adjustments to the account. Available for current year
       and 3 prior tax years. Most requests will be processed within 30 calendar days
 7      Verification of Nonfiling, which is proof from the IRS that you did not file a return for the year. Most requests will be processed
        within 10 business days
 8      Form W-2, Form 1099 series, Form 1098 series, or Form 5498 series transcript. The IRS can provide a transcript that includes data from
        these information returns. State or local information is not included with the Form W-2 information. The IRS may be able to provide this transcript
        information for up to 10 years. Information for the current year is generally not available until the year after it is filed with the IRS. For example,
        W-2 information for 2006, filed in 2007, will not be available from the IRS until 2008. If you need W-2 information for retirement purposes, you
        should contact the Social Security Administration at 1-800-772-1213. Most requests will be processed within 45 days
Caution: If you need a copy of Form W-2 or Form 1099, you should first contact the payer. To get a copy of the Form W-2 or Form 1099
filed with your return, you must use Form 4506 and request a copy of your return, which includes all attachments.
 9      Year or period requested. Enter the ending date of the year or period, using the mm/dd/yyyy format. If you are requesting more than four
        years or periods, you must attach another Form 4506-T. For requests relating to quarterly tax returns, such as Form 941, you must enter
        each quarter or tax period separately.
                /         /                                      /         /                       /         /                                /         /

Signature of taxpayer(s). I declare that I am either the taxpayer whose name is shown on line 1a or 2a, or a person authorized to obtain the tax
information requested. If the request applies to a joint return, either husband or wife must sign. If signed by a corporate officer, partner,
guardian, tax matters partner, executor, receiver, administrator, trustee, or party other than the taxpayer, I certify that I have the authority to
execute Form 4506-T on behalf of the taxpayer.
                                                                                                                            Telephone number of taxpayer on
                                                                                                                            line 1a or 2a
                                                                                                                            (       )

Sign
               Signature (see instructions)                                                    Date

Here           Title (if line 1a above is a corporation, partnership, estate, or trust)


               Spouse’s signature                                                              Date

For Privacy Act and Paperwork Reduction Act Notice, see page 2.                                    Cat. No. 37667N                Form 4506-T (Rev. 1-2008)
BNC National Bank                                                                          5                               Small Business Loan Application
Form 4506-T (Rev. 1-2008)                                                                                                                Page   2

General Instructions                                Chart for all other transcripts                   Partnerships. Generally, Form 4506-T
                                                                                                   can be signed by any person who was a
Purpose of form. Use Form 4506-T to                 If you lived in or      Mail or fax to the     member of the partnership during any part
request tax return information. You can             your business           “Internal Revenue      of the tax period requested on line 9.
also designate a third party to receive the         was in:                 Service” at:              All others. See Internal Revenue Code
information. See line 5.
                                                    Alabama, Alaska,                               section 6103(e) if the taxpayer has died, is
Tip. Use Form 4506, Request for Copy of             Arizona, Arkansas,                             insolvent, is a dissolved corporation, or if a
Tax Return, to request copies of tax                California, Colorado,                          trustee, guardian, executor, receiver, or
returns.                                            Florida, Georgia,                              administrator is acting for the taxpayer.
Where to file. Mail or fax Form 4506-T to           Hawaii, Idaho, Iowa,                           Documentation. For entities other than
the address below for the state you lived           Kansas, Louisiana,                             individuals, you must attach the
                                                    Minnesota,              RAIVS Team
in, or the state your business was in, when                                 P.O. Box 9941          authorization document. For example, this
that return was filed. There are two                Mississippi,                                   could be the letter from the principal officer
                                                    Missouri, Montana,      Mail Stop 6734
address charts: one for individual                                          Ogden, UT 84409        authorizing an employee of the corporation
transcripts (Form 1040 series and Form              Nebraska, Nevada,
                                                                                                   or the Letters Testamentary authorizing an
W-2) and one for all other transcripts.             New Mexico,
                                                                                                   individual to act for an estate.
                                                    North Dakota,
   If you are requesting more than one              Oklahoma, Oregon,
transcript or other product and the chart           South Dakota,
below shows two different RAIVS teams,              Tennessee, Texas,                              Privacy Act and Paperwork Reduction
send your request to the team based on              Utah, Washington,                              Act Notice. We ask for the information on
the address of your most recent return.             Wyoming, a foreign                             this form to establish your right to gain
                                                    country, or A.P.O. or                          access to the requested tax information
Note. You can also call 1-800-829-1040 to                                                          under the Internal Revenue Code. We need
request a transcript or get more                    F.P.O. address          801-620-6922
                                                                                                   this information to properly identify the tax
information.                                        Connecticut,                                   information and respond to your request.
                                                    Delaware, District of
                                                                                                   Sections 6103 and 6109 require you to
                                                    Columbia, Illinois,
Chart for individual                                Indiana, Kentucky,
                                                                                                   provide this information, including your
transcripts (Form 1040 series                                                                      SSN or EIN. If you do not provide this
                                                    Maine, Maryland,
                                                                                                   information, we may not be able to
and Form W-2)                                       Massachusetts,
                                                    Michigan, New           RAIVS Team             process your request. Providing false or
If you filed an             Mail or fax to the      Hampshire, New          P.O. Box 145500        fraudulent information may subject you to
individual return           “Internal Revenue       Jersey, New York,       Stop 2800 F            penalties.
and lived in:               Service” at:            North Carolina,         Cincinnati, OH 45250      Routine uses of this information include
                                                    Ohio, Pennsylvania,                            giving it to the Department of Justice for
District of Columbia,       RAIVS Team              Rhode Island, South                            civil and criminal litigation, and cities,
Maine, Maryland,            Stop 679                Carolina, Vermont,                             states, and the District of Columbia for use
Massachusetts,              Andover, MA 05501       Virginia, West                                 in administering their tax laws. We may
New Hampshire,                                      Virginia, Wisconsin     859-669-3592           also disclose this information to other
New York,
                                                                                                   countries under a tax treaty, to federal and
Vermont                     978-247-9255            Line 1b. Enter your employer identification    state agencies to enforce federal nontax
Alabama, Delaware,          RAIVS Team              number (EIN) if your request relates to a      criminal laws, or to federal law
Florida, Georgia,           P.O. Box 47-421         business return. Otherwise, enter the first    enforcement and intelligence agencies to
North Carolina,             Stop 91                 social security number (SSN) shown on the      combat terrorism.
Rhode Island,               Doraville, GA 30362     return. For example, if you are requesting        You are not required to provide the
South Carolina,                                     Form 1040 that includes Schedule C             information requested on a form that is
Virginia                    770-455-2335            (Form 1040), enter your SSN.                   subject to the Paperwork Reduction Act
Kentucky, Louisiana,        RAIVS Team              Line 6. Enter only one tax form number per     unless the form displays a valid OMB
Mississippi,                Stop 6716 AUSC          request.                                       control number. Books or records relating
Tennessee, Texas, a         Austin, TX 73301                                                       to a form or its instructions must be
foreign country, or                                 Signature and date. Form 4506-T must be        retained as long as their contents may
A.P.O. or F.P.O.                                    signed and dated by the taxpayer listed on     become material in the administration of
address                     512-460-2272            line 1a or 2a. If you completed line 5         any Internal Revenue law. Generally, tax
Alaska, Arizona,            RAIVS Team              requesting the information be sent to a        returns and return information are
California, Colorado,       Stop 37106              third party, the IRS must receive Form         confidential, as required by section 6103.
Hawaii, Idaho, Iowa,        Fresno, CA 93888        4506-T within 60 days of the date signed          The time needed to complete and file
Kansas, Minnesota,                                  by the taxpayer or it will be rejected.        Form 4506-T will vary depending on
Montana, Nebraska,                                     Individuals. Transcripts of jointly filed   individual circumstances. The estimated
Nevada, New Mexico,                                 tax returns may be furnished to either         average time is: Learning about the law
North Dakota,                                       spouse. Only one signature is required.        or the form, 10 min.; Preparing the form,
Oklahoma, Oregon,                                   Sign Form 4506-T exactly as your name          12 min.; and Copying, assembling, and
South Dakota, Utah,                                 appeared on the original return. If you        sending the form to the IRS, 20 min.
Washington,                                         changed your name, also sign your current
Wisconsin, Wyoming          559-456-5876                                                              If you have comments concerning the
                                                    name.                                          accuracy of these time estimates or
Arkansas,                   RAIVS Team                 Corporations. Generally, Form 4506-T        suggestions for making Form 4506-T
Connecticut, Illinois,      Stop 6705–B41           can be signed by: (1) an officer having        simpler, we would be happy to hear from
Indiana, Michigan,          Kansas City, MO 64999   legal authority to bind the corporation, (2)   you. You can write to the Internal Revenue
Missouri, New                                       any person designated by the board of          Service, Tax Products Coordinating
Jersey, Ohio,                                       directors or other governing body, or (3)      Committee, SE:W:CAR:MP:T:T:SP, 1111
Pennsylvania,                                       any officer or employee on written request     Constitution Ave. NW, IR-6526,
West Virginia               816-292-6102            by any principal officer and attested to by    Washington, DC 20224. Do not send the
                                                    the secretary or other officer.                form to this address. Instead, see Where to
                                                                                                   file on this page.
Business Debt Schedule
Company Name: _________________________________________________________________                        Date (Same as Interim Balance Sheet):________________
This schedule should include loans, contracts/notes payable and lines of credit – not accounts payables or accrued liabilities.
               Creditor                                                  Term or
                                           Original        Original                        Present      Interest      Monthly         Collateral                What Was
                                                                         Maturity
             Name/Address                   Date           Amount                          Balance        Rate        Payment         or Security              Loan For? *
                                                                          Date
                                                               total Present Balance
  (*Total must agree with balance shown on Interim Balance Sheet)
     This_is_certified_correct_to_the_best_of_my_knowledge_this__________day_of______________________________,_20_______.
     _____________________________________            _____________________
       Signature                                       Title
BNC National Bank                                                                      7                                                    Small Business Loan Application
Business History
Company Name _____________________________________________________________________________________________

Nature of Business ___________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________

Type of Products/Services______________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________

Is your business seasonal? _____________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________

Future_Plans_for_Growth/Expansion ______________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________

How_Will_This_Loan_Benefit_Your_Company? ______________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________

Will the Funding of this Loan Create New Employment Opportunities?__________________________________________________
If so, state how ______________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________

Customer_Profile _____________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________

List Key Customers____________________________________       List Major Competitors _________________________________
____________________________________________________         ____________________________________________________
____________________________________________________         ____________________________________________________
                                                             ____________________________________________________
Major Suppliers_______________________________________       ____________________________________________________
____________________________________________________         ____________________________________________________
____________________________________________________         ____________________________________________________


Does_any_one_customer_comprise_more_than_20%_of_revenues? _________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________

Does_any_one_supplier_comprise_more_than_20%_of_purchases? _________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________

BNC National Bank                                        8                              Small Business Loan Application
                                                                                                                                  OMB APPROVAL NO. 3245-0188
                                                                                                                                  EXPIRATION DATE:3/31/2008

                                                                         PERSONAL FINANCIAL STATEMENT

  U.S. SMALL BUSINESS ADMINISTRATION                                                                          As of                            ,
Complete this form for: (1) each proprietor, or (2) each limited partner who owns 20% or more interest and each general partner, or (3) each stockholder owning
20% or more of voting stock, or (4) any person or entity providing a guaranty on the loan.
Name                                                                                                                     Business Phone

Residence Address                                                                                                        Residence Phone

City, State, & Zip Code

Business Name of Applicant/Borrower

                                           ASSETS                            (Omit Cents)                                      LIABILITIES                (Omit Cents)
Cash on hand & in Banks                                              $                      Accounts Payable                                         $
Savings Accounts                                                     $                      Notes Payable to Banks and Others                        $
IRA or Other Retirement Account                                      $                           (Describe in Section 2)
Accounts & Notes Receivable                                          $                      Installment Account (Auto)                               $
Life Insurance-Cash Surrender Value Only                             $                           Mo. Payments          $
    (Complete Section 8)                                                                    Installment Account (Other)                              $
Stocks and Bonds                                                     $                           Mo. Payments          $
   (Describe in Section 3)                                                                  Loan on Life Insurance                                   $
Real Estate                                                          $                      Mortgages on Real Estate                                 $
   (Describe in Section 4)                                                                       (Describe in Section 4)
Automobile-Present Value                                             $                      Unpaid Taxes                                             $
Other Personal Property                                              $                           (Describe in Section 6)
   (Describe in Section 5)                                                                  Other Liabilities                                        $
Other Assets                                                         $                           (Describe in Section 7)
   (Describe in Section 5)                                                                  Total Liabilities                                        $
                                                                                            Net Worth                                                $
                                               Total                 $                                                            Total              $
Section 1.        Source of Income                                                          Contingent Liabilities
Salary                                                               $                      As Endorser or Co-Maker                                  $
Net Investment Income                                                $                      Legal Claims & Judgments                                 $
Real Estate Income                                                   $                      Provision for Federal Income Tax                         $
Other Income (Describe below)*                                       $                      Other Special Debt                                       $
Description of Other Income in Section 1.




*Alimony or child support payments need not be disclosed in "Other Income" unless it is desired to have such payments counted toward total income.

Section 2. Notes Payable to Banks and Others.                  (Use attachments if necessary. Each attachment must be identified as a part of this statement and signed.)


             Name and Address of Noteholder(s)                              Original    Current    Payment        Frequency               How Secured or Endorsed
                                                                            Balance     Balance    Amount        (monthly,etc.)              Type of Collateral




SBA Form 413 (3-05) Previous Editions Obsolete                                                                                                                      (tumble)
This form was electronically produced by Elite Federal Forms, Inc.
Section 3. Stocks and Bonds. (Use attachments if necessary. Each attachment must be identified as a part of this statement and signed).
Number of Shares              Name of Securities                   Cost           Market Value               Date of             Total Value
                                                                              Quotation/Exchange Quotation/Exchange




Section 4. Real Estate Owned.             (List each parcel separately. Use attachment if necessary. Each attachment must be identified as a part
                                          of this statement and signed.)
                                                         Property A                            Property B                             Property C
Type of Property


Address


Date Purchased

Original Cost

Present Market Value

Name &
Address of Mortgage Holder

Mortgage Account Number

Mortgage Balance

Amount of Payment per Month/Year

Status of Mortgage
                                                                (Describe, and if any is pledged as security, state name and address of lien holder, amount of lien, terms
Section 5. Other Personal Property and Other Assets.
                                                                of payment and if delinquent, describe delinquency)




Section 6.       Unpaid Taxes.        (Describe in detail, as to type, to whom payable, when due, amount, and to what property, if any, a tax lien attaches.)




Section 7.       Other Liabilities.   (Describe in detail.)




Section 8.       Life Insurance Held.       (Give face amount and cash surrender value of policies - name of insurance company and beneficiaries)




  I authorize SBA/Lender to make inquiries as necessary to verify the accuracy of the statements made and to determine my creditworthiness. I certify the above
 and the statements contained in the attachments are true and accurate as of the stated date(s). These statements are made for the purpose of either obtaining
 a loan or guaranteeing a loan. I understand FALSE statements may result in forfeiture of benefits and possible prosecution by the U.S. Attorney General
 (Reference 18 U.S.C. 1001).

Signature:                                                                            Date:                     Social Security Number:


Signature:                                                                            Date:                     Social Security Number:
PLEASE NOTE:         The estimated average burden hours for the completion of this form is 1.5 hours per response. If you have questions or comments
                     concerning this estimate or any other aspect of this information, please contact Chief, Administrative Branch, U.S. Small Business
                     Administration, Washington, D.C. 20416, and Clearance Officer, Paper Reduction Project (3245-0188), Office of Management and Budget,
                     Washington, D.C. 20503. PLEASE DO NOT SEND FORMS TO OMB.
                                                                                                                                                                       OMB APPROVAL NO.3245-0178
                                                                          Return Executed Copies 1, 2, and 3 to SBA                                                        Expiration Date:12/31/2009
                                                                                                                                  Please Read Carefully - Print or Type
                                                                                                        Each member of the small business or the development company requesting assistance
                                           United States of America                                     must submit this form in TRIPLICATE for filing with the SBA application. This form must
                                                                                                        be filled out and submitted by:
                              SMALL BUSINESS ADMINISTRATION                                             1. By the proprietor, if a sole proprietorship.
                                                                                                        2. By each partner, if a partnership.
                             STATEMENT OF PERSONAL HISTORY
                                                                                                        3. By each officer, director, and additionally by each holder of 20% or more of the
                                                                                                           ownership stock, if a corporation, limited liability company, or a development company.

Name and Address of Applicant (Firm Name)(Street, City, State, and ZIP Code)                            SBA District/Disaster Area Office


                                                                                                        Amount Applied for (when applicable)             File No. (if known)


1.    Personal Statement of: (State name in full, if no middle name, state (NMN), or if initial         2. Give the percentage of ownership or stocked owned Social Security No.
      only, indicate initial.) List all former names used, and dates each name was used.                   or to be owned in the small business or the
      Use separate sheet if necessary.                                                                     development company

      First                              Middle                              Last                       3. Date of Birth (Month, day, and year)


                                                                                                        4. Place of Birth: (City & State or Foreign Country)



 Name and Address of participating lender or surety co. (when applicable and kno wn)                    5. U.S. Citizen?          YES            NO
                                                                                                        If No, are you a Lawful             YES          NO
                                                                                                        Permanent resident alien:
                                                                                                        If non- U.S. citizen provide alien registration number:

6. Present residence address:                                                                           Most recent prior address (omit if over 10 years ago):
      From:                                                                                             From:
      To:                                                                                               To:
      Address:                                                                                          Address:

      Home Telephone No. (Include A/C):
      Business Telephone No. (Include A/C):
PLEASE SEE REVERSE SIDE FOR EXPLANATION REGARDING DISCLOSURE OF INFORMATION AND THE USES OF SUCH INFORMATION.

IT IS IMPORTANT THAT THE NEXT THREE QUESTIONS BE ANSWERED COMPLETELY. AN ARREST OR CONVICTION RECORD WILL NOT
NECESSARILY DISQUALIFY YOU; HOWEVER, AN UNTRUTHFUL ANSWER WILL CAUSE YOUR APPLICATION TO BE DENIED.

IF YOU ANSWER "YES" TO 7, 8, OR 9, FURNISH DETAILS ON A SEPARATE SHEET. INCLUDE DATES, LOCATION, FINES, SENTENCES, WHETHER
MISDEMEANOR OR FELONY, DATES OF PAROLE/PROBATION, UNPAID FINES OR PENALTIES, NAME(S) UNDER WHICH CHARGED, AND ANY
OTHER PERTINENT INFORMATION.

 7. Are you presently under indictment, on parole or probation?

                 Yes            No           (If yes, indicate date parole or probation is to expire.)

 8. Have you ever been charged with and or arrested for any criminal offense other than a minor motor vehicle violation? Include offenses which have been dismissed, discharged, or
    not prosecuted (All arrests and charges must be disclosed and explained on an attached sheet.)

                Yes             No

 9. Have you ever been convicted, placed on pretrial diversion, or placed on any form of probati on, including adjudication withheld pending probation, for any criminal offense other
    than a minor vehicle violation?
                Yes              No
10. I authorize the Small Business Administration Office of Inspector General to request criminal record information about me from criminal justice agencies for the purpose of
    determining my eligibility for programs authorized by the Small Business Act, and the Small Business Investment Act.

CAUTION: Knowingly making a false statement on this form is a violation of Federal law and could result in criminal prosecution, significant civil penalties, and a denial of your loan,
surety bond, or other program participation. A false statement is punishable under 18 USC 1001 by imprisonment of not more than five years and/or a fine of not more than $10,000;
under 15 USC 645 by imprisonment of not more than two years and/or a fine of not more than $5,000; and, if submitted to a Federally insured institution, under 18 USC 1014 by
imprisonment of not more than thirty years and/or a fine of not more than $1,000,000.

Signature                                                                     Title                                                                                        Date


Agency Use Only
                                                                                                        12.      Cleared for Processing                     Date               Approving Authority
11.           Fingerprints Waived
                                                  Date                Approving Authority
                                                                                                        13.      Request a Character Evaluation
              Fingerprints Required                                                                                                                         Date               Approving Authority
                                                  Date                Approving Authority
     Date Sent to OIG                                                                                      (Required whenever 7, 8 or 9 are answered "yes" even if cleared for processing.)

 PLEASE NOTE: The estimated burden for completing this form is 15 minutes per re sponse. You are not required to respond to any collection of information un less it displays a currently valid OMB
 approval number. Comments on the burden should be sent to U.S. Small Business Administration, Chief, AIB, 409 3rd St., S.W., Washington D.C. 20416 and Desk Officer for the Small Business
 Administration, Office of Management and Budget, New Executive Office Building, Room 10202, Washington, D.C. 20503. OMB Approval 3245-0178. PLEASE DO NOT SEND FORMS TO OMB.


SBA 912 (12-06) SOP 5010.4 Previous Edition Obsolete                                                                                      This form was electronically produced by Elite Federal Forms, Inc.
                                         NOTICES REQUIRED BY LAW

The following is a brief summary of the laws applicable to this solicitation of information.

Paperwork Reduction Act (44 U.S.C. Chapter 35)

SBA is collecting the information on this form to make a character and credit eligibility decision to fund or deny you
a loan or other form of assistance. The information is required in order for SBA to have sufficient information to
determine whether to provide you with the requested assistance. The information collected may be checked
against criminal history indices of the Federal Bureau of Investigation.

Privacy Act (5 U.S.C. § 552a)

Any person can request to see or get copies of any personal information that SBA has in his or her file, when that
file is retrievable by individual identifiers, such as name or social security numbers. Requests for information about
another party may be denied unless SBA has the written permission of the individual to release the information to
the requestor or unless the information is subject to disclosure under the Freedom of Information Act.

Under the provisions of the Privacy Act, you are not required to provide your social security number. Failure to
provide your social security number may not affect any right, benefit or privilege to which you are entitled.
Disclosures of name and other personal identifiers are, however, required for a benefit, as SBA requires an
individual seeking assistance from SBA to provide it with sufficient information for it to make a character
determination. In determining whether an individual is of good character, SBA considers the person's integrity,
candor, and disposition toward criminal actions. In making loans pursuant to section 7(a)(6) the Small Business
Act (the Act), 15 USC § 636 (a)(6), SBA is required to have reasonable assurance that the loan is of sound value
and will be repaid or that it is in the best interest of the Government to grant the assistance requested.
Additionally, SBA is specifically authorized to verify your criminal history, or lack thereof, pursuant to section
7(a)(1)(B), 15 USC § 636(a)(1)(B). Further, for all forms of assistance, SBA is authorized to make all
investigations necessary to ensure that a person has not engaged in acts that violate or will violate the Act or the
Small Business Investment Act,15 USC §§ 634(b)(11) and 687b(a). For these purposes, you are asked to
voluntarily provide your social security number to assist SBA in making a character determination and to
distinguish you from other individuals with the same or similar name or other personal identifier.

When this information indicates a violation or potential violation of law, whether civil, criminal, or administrative in
nature, SBA may refer it to the appropriate agency, whether Federal, State, local, or foreign, charged with
responsibility for or otherwise involved in investigation, prosecution, enforcement or prevention of such violations.
See 56 Fed. Reg. 8020 (1991) for other published routine uses.
Form    4506-T                             
                                                   Request for Transcript of Tax Return
                                             Do not sign this form unless all applicable lines have been completed.
                                                               Read the instructions on page 2.                                                OMB No. 1545-1872
(Rev. January 2008)
Department of the Treasury
                                          Request may be rejected if the form is incomplete, illegible, or any required
Internal Revenue Service                                   line was blank at the time of signature.
Tip: Use Form 4506-T to order a transcript or other return information free of charge. See the product list below. You can also call 1-800-829-1040 to
order a transcript. If you need a copy of your return, use Form 4506, Request for Copy of Tax Return. There is a fee to get a copy of your return.
 1a Name shown on tax return. If a joint return, enter the name shown first.                        1b First social security number on tax return or
                                                                                                       employer identification number (see instructions)


 2a If a joint return, enter spouse’s name shown on tax return                                      2b Second social security number if joint tax return



 3      Current name, address (including apt., room, or suite no.), city, state, and ZIP code



 4      Previous address shown on the last return filed if different from line 3



 5      If the transcript or tax information is to be mailed to a third party (such as a mortgage company), enter the third party’s name, address,
        and telephone number. The IRS has no control over what the third party does with the tax information.




Caution: DO NOT SIGN this form if a third party requires you to complete Form 4506-T, and lines 6 and 9 are blank.
 6      Transcript requested. Enter the tax form number here (1040, 1065, 1120, etc.) and check the appropriate box below. Enter only one tax
        form number per request. 
     a Return Transcript, which includes most of the line items of a tax return as filed with the IRS. Transcripts are only available for
        the following returns: Form 1040 series, Form 1065, Form 1120, Form 1120A, Form 1120H, Form 1120L, and Form 1120S.
        Return transcripts are available for the current year and returns processed during the prior 3 processing years. Most requests
        will be processed within 10 business days

     b Account Transcript, which contains information on the financial status of the account, such as payments made on the account, penalty
       assessments, and adjustments made by you or the IRS after the return was filed. Return information is limited to items such as tax liability
       and estimated tax payments. Account transcripts are available for most returns. Most requests will be processed within 30 calendar days
     c Record of Account, which is a combination of line item information and later adjustments to the account. Available for current year
       and 3 prior tax years. Most requests will be processed within 30 calendar days
 7      Verification of Nonfiling, which is proof from the IRS that you did not file a return for the year. Most requests will be processed
        within 10 business days
 8      Form W-2, Form 1099 series, Form 1098 series, or Form 5498 series transcript. The IRS can provide a transcript that includes data from
        these information returns. State or local information is not included with the Form W-2 information. The IRS may be able to provide this transcript
        information for up to 10 years. Information for the current year is generally not available until the year after it is filed with the IRS. For example,
        W-2 information for 2006, filed in 2007, will not be available from the IRS until 2008. If you need W-2 information for retirement purposes, you
        should contact the Social Security Administration at 1-800-772-1213. Most requests will be processed within 45 days
Caution: If you need a copy of Form W-2 or Form 1099, you should first contact the payer. To get a copy of the Form W-2 or Form 1099
filed with your return, you must use Form 4506 and request a copy of your return, which includes all attachments.
 9      Year or period requested. Enter the ending date of the year or period, using the mm/dd/yyyy format. If you are requesting more than four
        years or periods, you must attach another Form 4506-T. For requests relating to quarterly tax returns, such as Form 941, you must enter
        each quarter or tax period separately.
                /         /                                      /         /                       /         /                                  /       /

Signature of taxpayer(s). I declare that I am either the taxpayer whose name is shown on line 1a or 2a, or a person authorized to obtain the tax
information requested. If the request applies to a joint return, either husband or wife must sign. If signed by a corporate officer, partner,
guardian, tax matters partner, executor, receiver, administrator, trustee, or party other than the taxpayer, I certify that I have the authority to
execute Form 4506-T on behalf of the taxpayer.
                                                                                                                            Telephone number of taxpayer on
                                                                                                                            line 1a or 2a
                                                                                                                            (       )

Sign
               Signature (see instructions)                                                    Date

Here           Title (if line 1a above is a corporation, partnership, estate, or trust)


               Spouse’s signature                                                              Date

For Privacy Act and Paperwork Reduction Act Notice, see page 2.                                    Cat. No. 37667N                      Form   4506-T   (Rev. 1-2008)
Form 4506-T (Rev. 1-2008)                                                                                                                Page   2

General Instructions                                Chart for all other transcripts                   Partnerships. Generally, Form 4506-T
                                                                                                   can be signed by any person who was a
Purpose of form. Use Form 4506-T to                 If you lived in or      Mail or fax to the     member of the partnership during any part
request tax return information. You can             your business           “Internal Revenue      of the tax period requested on line 9.
also designate a third party to receive the         was in:                 Service” at:              All others. See Internal Revenue Code
information. See line 5.
                                                    Alabama, Alaska,                               section 6103(e) if the taxpayer has died, is
Tip. Use Form 4506, Request for Copy of             Arizona, Arkansas,                             insolvent, is a dissolved corporation, or if a
Tax Return, to request copies of tax                California, Colorado,                          trustee, guardian, executor, receiver, or
returns.                                            Florida, Georgia,                              administrator is acting for the taxpayer.
Where to file. Mail or fax Form 4506-T to           Hawaii, Idaho, Iowa,                           Documentation. For entities other than
the address below for the state you lived           Kansas, Louisiana,                             individuals, you must attach the
                                                    Minnesota,              RAIVS Team
in, or the state your business was in, when                                 P.O. Box 9941          authorization document. For example, this
that return was filed. There are two                Mississippi,                                   could be the letter from the principal officer
                                                    Missouri, Montana,      Mail Stop 6734
address charts: one for individual                                          Ogden, UT 84409        authorizing an employee of the corporation
transcripts (Form 1040 series and Form              Nebraska, Nevada,
                                                                                                   or the Letters Testamentary authorizing an
W-2) and one for all other transcripts.             New Mexico,
                                                                                                   individual to act for an estate.
                                                    North Dakota,
   If you are requesting more than one              Oklahoma, Oregon,
transcript or other product and the chart           South Dakota,
below shows two different RAIVS teams,              Tennessee, Texas,                              Privacy Act and Paperwork Reduction
send your request to the team based on              Utah, Washington,                              Act Notice. We ask for the information on
the address of your most recent return.             Wyoming, a foreign                             this form to establish your right to gain
                                                    country, or A.P.O. or                          access to the requested tax information
Note. You can also call 1-800-829-1040 to                                                          under the Internal Revenue Code. We need
request a transcript or get more                    F.P.O. address          801-620-6922
                                                                                                   this information to properly identify the tax
information.                                        Connecticut,                                   information and respond to your request.
                                                    Delaware, District of
                                                                                                   Sections 6103 and 6109 require you to
                                                    Columbia, Illinois,
Chart for individual                                Indiana, Kentucky,
                                                                                                   provide this information, including your
transcripts (Form 1040 series                                                                      SSN or EIN. If you do not provide this
                                                    Maine, Maryland,
                                                                                                   information, we may not be able to
and Form W-2)                                       Massachusetts,
                                                    Michigan, New           RAIVS Team             process your request. Providing false or
If you filed an             Mail or fax to the      Hampshire, New          P.O. Box 145500        fraudulent information may subject you to
individual return           “Internal Revenue       Jersey, New York,       Stop 2800 F            penalties.
and lived in:               Service” at:            North Carolina,         Cincinnati, OH 45250      Routine uses of this information include
                                                    Ohio, Pennsylvania,                            giving it to the Department of Justice for
District of Columbia,       RAIVS Team              Rhode Island, South                            civil and criminal litigation, and cities,
Maine, Maryland,            Stop 679                Carolina, Vermont,                             states, and the District of Columbia for use
Massachusetts,              Andover, MA 05501       Virginia, West                                 in administering their tax laws. We may
New Hampshire,                                      Virginia, Wisconsin     859-669-3592           also disclose this information to other
New York,
                                                                                                   countries under a tax treaty, to federal and
Vermont                     978-247-9255            Line 1b. Enter your employer identification    state agencies to enforce federal nontax
Alabama, Delaware,          RAIVS Team              number (EIN) if your request relates to a      criminal laws, or to federal law
Florida, Georgia,           P.O. Box 47-421         business return. Otherwise, enter the first    enforcement and intelligence agencies to
North Carolina,             Stop 91                 social security number (SSN) shown on the      combat terrorism.
Rhode Island,               Doraville, GA 30362     return. For example, if you are requesting        You are not required to provide the
South Carolina,                                     Form 1040 that includes Schedule C             information requested on a form that is
Virginia                    770-455-2335            (Form 1040), enter your SSN.                   subject to the Paperwork Reduction Act
Kentucky, Louisiana,        RAIVS Team              Line 6. Enter only one tax form number per     unless the form displays a valid OMB
Mississippi,                Stop 6716 AUSC          request.                                       control number. Books or records relating
Tennessee, Texas, a         Austin, TX 73301                                                       to a form or its instructions must be
foreign country, or                                 Signature and date. Form 4506-T must be        retained as long as their contents may
A.P.O. or F.P.O.                                    signed and dated by the taxpayer listed on     become material in the administration of
address                     512-460-2272            line 1a or 2a. If you completed line 5         any Internal Revenue law. Generally, tax
Alaska, Arizona,            RAIVS Team              requesting the information be sent to a        returns and return information are
California, Colorado,       Stop 37106              third party, the IRS must receive Form         confidential, as required by section 6103.
Hawaii, Idaho, Iowa,        Fresno, CA 93888        4506-T within 60 days of the date signed          The time needed to complete and file
Kansas, Minnesota,                                  by the taxpayer or it will be rejected.        Form 4506-T will vary depending on
Montana, Nebraska,                                     Individuals. Transcripts of jointly filed   individual circumstances. The estimated
Nevada, New Mexico,                                 tax returns may be furnished to either         average time is: Learning about the law
North Dakota,                                       spouse. Only one signature is required.        or the form, 10 min.; Preparing the form,
Oklahoma, Oregon,                                   Sign Form 4506-T exactly as your name          12 min.; and Copying, assembling, and
South Dakota, Utah,                                 appeared on the original return. If you        sending the form to the IRS, 20 min.
Washington,                                         changed your name, also sign your current
Wisconsin, Wyoming          559-456-5876                                                              If you have comments concerning the
                                                    name.                                          accuracy of these time estimates or
Arkansas,                   RAIVS Team                 Corporations. Generally, Form 4506-T        suggestions for making Form 4506-T
Connecticut, Illinois,      Stop 6705–B41           can be signed by: (1) an officer having        simpler, we would be happy to hear from
Indiana, Michigan,          Kansas City, MO 64999   legal authority to bind the corporation, (2)   you. You can write to the Internal Revenue
Missouri, New                                       any person designated by the board of          Service, Tax Products Coordinating
Jersey, Ohio,                                       directors or other governing body, or (3)      Committee, SE:W:CAR:MP:T:T:SP, 1111
Pennsylvania,                                       any officer or employee on written request     Constitution Ave. NW, IR-6526,
West Virginia               816-292-6102            by any principal officer and attested to by    Washington, DC 20224. Do not send the
                                                    the secretary or other officer.                form to this address. Instead, see Where to
                                                                                                   file on this page.
Site History Form
For Commercial Properties only – residential home information is not applicable.
Applicant Name:____________________________________________________
Site Address:_______________________________________________________
             _______________________________________________________


                                                      Property Description

Lot Square Footage:_____________________ Building Square Footage:_____________________ Year Built: _________________
Construction Type: ___________________________________________________________________________________________
Condition:_______________________________________________________________________ No. of Floors: _______________
Present Use:_________________________________________________________________________________________________
Proposed Use: _______________________________________________________________________________________________
Proximity to Current Location: __________________________________________________________________________________
Owner_Occupied_Square_Feet:_______________,_(________%);_Tenant(s)_Occupied_Square_Feet:________________,_(________%)
Appraisal Contact Name:_________________________________________ Telephone: ___________________________________



                             Environmental Questionnaire (for all transactions):

q Yes q No Are you aware of any substances that have been used on the property, are being used on the property, or will be used
           onthe property which require permits or other regulatory control? If yes, please describe the substances and provide
           evidence of regulatory compliance.__________________________________________________________________

q Yes q No Are you presently aware of any past, present, or potential lawsuits, regulatory actions, or any environmental issues
           which may affect you, your proposed business, or the subject property? If yes, please describe. ___________________
           _______________________________________________________________________________________________

q Yes q No Are you aware of any past or present underground or aboveground storage tanks at the proposed location? If yes, please
           describe and specify age, contents, closure documents, etc. ________________________________________________
            _______________________________________________________________________________________________

q Yes q No Do you have any knowledge of any environmental site assessment of the property or facility that indicated the
           presence of hazardous substances or petroleum products on, or contamination of, the property, or recommended further
           assessment of the property? If yes, please describe. ______________________________________________________



Applicant agrees to disclose any additional environmental information about the property, including the existence of reports or
environmental assessments, discovered prior to settlement and provide copies to Lender, if requested, of any environmental reports or
assessments obtained prior to property settlement.



Please provide additional attachments as necessary.


_____________________________________            _____________________
 Signature                                        Date


_____________________________________            _____________________
 Print Name                                           Title


BNC National Bank                                                 15                                Small Business Loan Application
Projected Operating Statement
 Year________________                        Name of Business_________________________________________________________
                               Month 1    Month_2      Month 3   Month 4     Month 5    Month 6    Month 7     Month 8   Month 9 Month 10 Month 11 Month_12 TOTALS
   Gross_Sales
   Less:__Cost_of_Goods_Sold
   Less Expenses:
     Accounting & Legal
     Advertising
     Bad Debts
   _ Officer’s_Comp.
     Salaries & Wages
     Rent
     Insurance
     Repairs & Maint.
     Depreciation
     Interest
     Other Expenses
   Total Expenses
   Operating Income
   Taxes
   Net_Profit
 This_is_certified_correct_to_the_best_of_my_knowledge_this__________day_of______________________________,_20_______.
 _____________________________________            _____________________
  Signature                                         Title
BNC National Bank                                                                        16                                                 Small Business Loan Application
Privacy Statement
At the BNCCORP, Inc. (BNC) family of financial service providers, which includes BNC National Bank, the basis
of each customer relationship is trust. You have chosen to do business with BNC and we are obligated to honor that
relationship with great care, beginning with the information you have chosen to share with us. We believe your privacy
should not be compromised. At the same time, we want to offer you the array of financial products and services you need
to accomplish your financial goals. We believe we can do both through the privacy policy outlined below.

Recognition of Customer’s Expectation of Privacy
At BNC, we believe the confidentiality and protection of customer information is one of our fundamental
responsibilities. And while information is critical to providing quality service, we recognize that one of our most
important assets is our customers’ trust. Thus, the safekeeping of customer information is a priority for BNC.

Collection and Disclosure of Information
We collect, retain, and use information about you only where we reasonably believe it will help administer our business
or provide products, services, and other opportunities to you. We collect nonpublic personal information about you from
the following sources:

 •	 Information	we	receive	from	you	on	applications	or	other	forms;

 •	 Information	about	your	transactions	with	us,	our	affiliates,	or	others;	and

 •	 Information	we	receive	from	a	consumer	reporting	agency.

          We may disclose all of the information that we collect, as disclosed above, to companies that are affiliated with
          us. This internal sharing allows us to provide you with opportunities to obtain a wide variety of products and
          services from us. If you prefer that we don’t share nonpublic personal and credit-related information about you
          with the companies affiliated with us, you may choose to opt out. If you wish to exercise this right, please go
          to www.bncbank.com and click on the Privacy Statement link found at the bottom of the page. You can then
          complete the Opt Out Form and choose submit or email your request to us at web@bncbank.com. If you do
          not have internet access you may call 1-800-BNC-BANK (1-800-262-2265). Your choice to opt-out will be
          considered effective until it is revoked in writing. In accordance with the Fair Credit Reporting Act, we may
          share identifying information and information about your transactions and experiences within the BNC family
          whether or not you have opted out. For joint consumer accounts, any one of the joint account holders may
          exercise this right.

If you are a joint account holder and you exercise this right, your decision will also apply to others with whom you jointly
hold accounts.

We also may disclose the following information to companies that perform marketing services on our behalf or to other
financial institutions with whom we have joint marketing agreements:

   •	 Information	we	receive	from	you	on	applications	address,	and	Social	Security	number;

   •	 Information	about	your	transactions	with	us,	our	affiliates,	or	others,	such	as	your	account	balance,	credit	card	
      usage,	and	payment	history;	and

   •	Information	we	receive	from	a	consumer	reporting	agency,	such	as	your	creditworthiness	and	credit	history.




BNC National Bank                                             17                               Home Equity Loan Application
                                                                                       Privacy Statement (cont.)
These companies and contractors are subject to confidentiality provisions and restrictions that prohibit using information
beyond the performance of the specified services on our behalf. We do not disclose any nonpublic personal information
about our customers or former customers to nonaffiliated third parties unless:
   1)	you	request	or	authorize	it;	
   2)	the	information	is	provided	to	help	complete	a	transaction	initiated	by	you;	
   3)	the	information	is	provided	to	a	reputable	credit	bureau	or	similar	information	reporting	agency;	or	
   4) the disclosure otherwise is lawfully permitted or required.



Maintenance of Accurate Information
We continually strive to maintain complete and accurate information about you and your accounts. Should you ever
believe that our records contain inaccurate or incomplete information about you, please notify us. We will investigate
your concerns and correct any inaccuracies.


Confidentiality and Security
At BNC, employee access to nonpublic personal information is limited to those employees with a need to know such
information to provide products and/or services to you. We maintain physical, electronic, and procedural safeguards that
comply with federal standards to guard your nonpublic personal information. Employees are educated on the importance
of maintaining the confidentiality of customer information and on these Privacy Principles. Because of the importance
of these issues, all BNC employees are responsible for maintaining the confidentiality of customer information and
employees who violate these Privacy Principles will be subject to disciplinary measures.


Maintaining Customer Privacy in
Business Relationships with Third Parties
When BNC conducts business with third parties, it requires its vendors and suppliers to maintain similar standards of
conduct regarding the privacy of personally identifiable customer information provided to them. Providing Privacy
Information to Customers and Responding to Inquiries At BNC, we value our customer relationships. We want you to
understand how we use the information you provide and our commitment to ensuring your personal privacy. If you have
any questions about how BNC protects your confidential information, please call BNC at 1-800-262-2265 or e-mail us at
web@bncbank.com.




BNC National Bank                                           18                              Home Equity Loan Application

								
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