MBS Financial: SBA Express Form

SBA Express Loan

Help Qualified Small Businesses Obtain Financing

Purchase/Renovate

Leasehold Improvements

SBA Express Loan
Name of Individual:
Title:
Name of Business:
Business Address:
Business Phone:
Business Fax:
Business E-mail:
Federal I.D.#:
Type of Business:
Date Est.

Bank of Business Account:
Telephone:
Address:
Account Officer:
History of Business:


Creditor:
Monthly Payments:
Balance Outstanding:
Description:
Approximate Value:
Term of Agreement:

Creditor:
Monthly Payments:
Balance Outstanding:
Description:
Approximate Value:
Term of Agreement:

Do you have any co-signers and/or guarantors for this loan? Yes No
Is your business a franchise? Yes No
Do you or your business own or have interest in any other business? Yes No
Are you or your business involved in any pending lawsuits? Yes No
Have you or any officers of your company been involved in bankruptcy? Yes No
Have you or any principles of your business ever requested government financing?Yes No

If yes, complete the following
Name of agency:
Original amount:
Date of Request:
Approved or Declined:
Current Delivering: