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Primary Borrower Name: Title / Role:

Business Entity Type:

• Individual
• LLC
• Corporation
• Partnership
• Other:

Other

SSN / EIN:

Date of Birth / Incorporation:

Home / Business Address:

Phone:

Email:

Co-Borrower (if applicable):

Email (Co-Borrower):

Loan Amount Requested: Purpose of Loan

• Business Acquisition
• Working Capital
• Equipment Purchase
• Real Estate

Business to Be Acquired Name:

Business Location

Purchase Price:

Borrower Equity Injection:

Proposed Loan Term:

Number of Years

Preferred Loan Type

• SBA 7(a)
• SBA 504
• Conventional
• Asset-Based
• Other

Other: type here

Target Business Financial Snapshot Annual Gross Revenue (Most Recent

Annual Contracts Business

EBITDA / Net Operating Income

Total Assets Value

Total Liabilities

Fleet / Equipment Value

Contracts / Key Clients

Number of Years in Operation:

Employees

Borrower Financial Snapshot Credit Score (Approximate):

Net Worth:

Liquid Assets / Cash Available:

Annual Personal Income:

Personal Guarantees Available

• Yes
• No

Bankruptcy History

• Yes
• No

Business Ownership / Industry Experience:

• Trucking / Logistics
• Business Ownership
• Management

Briefly describe relevant background:

Submit

Documentation Checklist (Attach if available)

■ Executed Business Purchase Agreement
■ Business Financials (3 Years Tax Returns & P&L;)
■ Equipment List & Valuation
■ Borrower Personal Financial Statement
■ Business Plan / Projections
■ Credit Authorization Form
■ Entity Formation Documents (LLC / Corp)
■ Driver’s License / ID