Application: Private Equity Step 1 of 4 25% Business InformationLegal Business Name* DBA (Doing Business As) Date Business Established* MM slash DD slash YYYY EIN #*Leave out the -Entity Type*Not yet establishedCorporation (S or C)LLC / LLPPartnershipSole ProprietorNon ProfitIndustry*SelectAccounting/FinanceAdvertising/Public RelationsAerospace/AviationArts/Entertainment/PublishingAutomotiveBanking/MortgageBusiness DevelopmentBusiness OpportunityClerical/AdministrativeConstruction/FacilitiesConsumer GoodsCustomer ServiceEducation/TrainingEnergy/UtilitiesEngineeringGovernment/MilitaryGreenHealthcareHospitality/TravelHuman ResourcesInstallation/MaintenanceInsuranceInternetJob Search AidsLaw Enforcement/SecurityLegalManagement/ExecutiveManufacturing/OperationsMarketingNon-Profit/VolunteerPharmaceutical/BiotechProfessional ServicesQA/Quality ControlReal EstateRestaurant/Food ServiceRetailSalesScience/ResearchSkilled LaborTechnologyTelecommunicationsTransportation/LogisticsOtherBusiness Phone*Business Address* Street Address City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Business Bank InformationBusiness Bank Name* Annual Business Revenue*Bank Deposit Volume for the YearAverage Bank Balance* Business owner(s) information:List any owner with over 50% ownershipBusiness Owners Name* First Last SSN #*Date of Birth* MM slash DD slash YYYY Email* Cell Phone*Home PhoneOwners Address* Street Address City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Annual Income*% of Ownership*# of Additional owners*None12Additional Owner 1 InformationName First Last SSN #*Date of Birth* MM slash DD slash YYYY Email* Cell Phone*Home PhoneAddress Street Address City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Annual Income*% of OwnershipAdditional Owner 2 InformationName First Last SSN #*Date of Birth* MM slash DD slash YYYY Email* Cell Phone*Home PhoneAddress Street Address City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Annual Income*% of Ownership Desired Loan Amount*Purpose of loan*Business ExpansionCapital / Facility ImprovementsEquipment PurchaseInventory, Merchandise or GoodsNew LocationSales TransactionServicesDebt RefinancingInsurancePayablesWorking capitalOtherDesired Loan Term*6 Months9 Months12 Months15 Months18 Months6 months bank statements* Drop files here or Select files Max. file size: 64 MB. If you haven't already supplied them2 Years Business Tax Returns* Drop files here or Select files Max. file size: 64 MB. 1 Year Personal Tax Return* Drop files here or Select files Max. file size: 64 MB. Debt Schedule* Drop files here or Select files Max. file size: 64 MB. Business Profit and Loss Statement* Drop files here or Select files Max. file size: 64 MB. Year to DateSignatureApplicant authorizes Business Finance Suite to carry on a complete credit investigation of applicant and the principals as deems necessary to process this application. Furthermore, by signing below you certify that the statements above and on any attachments are true and complete as of the date given below.Signature*Date MM slash DD slash YYYY SignatureDate MM slash DD slash YYYY SignatureDate MM slash DD slash YYYY
