Working Capital Application

Working Capital Application
Name of Business:
Name of Individual:
Title:
Business Address:
Bus. Telephone:
Bus. Fax:
Bus. E-mail Address:
Fed. Employer's Tax ID#:
Type of Business:
Date Business Established:

Use of Proceeds:
Purchase of Land and Buildings:
Construction/Expansion of Building:
Leasehold Improvements:
Purchase of Machinery & Equipment:
Purchase of Furniture & Fixtures:
Debt Refinancing:
Payments of Accounts Payable:
Purchase of Inventory:
Cash-Working Capital:
Other:
Total Requested Loan Amount:
Please Mail the Following Items: Most recent balance sheet and operating statement. Previous year-end balance sheet and operating statement. Copy of business plan, if available. Listing of all owners-provide name, address, and percentage ownership. Listing of collateral offered and estimated value(s).

This form is also available as a download which can be faxed to 336-217-8155.
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