community futures strathcona loan application.pdf

7/27/2019 Community Futures Strathcona Loan Application.pdf

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Business Name: _________________________

Contact Name: _________________________

Phone Number: _________________________

Loan Application

900 Alder Street Campbell River BC V9W 2P6 T: 250-830-0999 www.cfstrathcona.ca


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BUSINESS INFORMATION

Is the business a start-up? Yes No

If NO, please provide the following:

Business Number (Tax Number) __________________________________________________

Business Website __________________________________________________

The business is/will be a Proprietorship Incorporation Partnership Other

If Incorporated, please provide a copy of certificate of incorporation together with financial statements for

the most recent three year-ends.

If Partnership, please provide a partnership agreement with the application.

If Other, please provide details: _______________________________________________________

Today, the business has _____ (number) full-time employees and _____ (number) part-time employees

After financing, the business will add _____ (number) full-time employees and add _____ (number) part-

time employees.

ELIGIBILITY

Has the business applied for funds elsewhere? Yes *

Name of bank? ______________________________________________________________

Reason for rejection? ______________________________________________________________

* CF Strathconas eligibility requirement is that a borrower is unable to obtain their financing from a bank or

credit union.

LOAN INFORMATION

I am contributing $______________ toward this project.

I am requesting $______________ from Community Futures Strathcona

Total project $______________ (Your contribution plus the request from CF Strathcona)


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I anticipate the monies for the total project will be used as follows:

$____________ For Equipment $____________ For Inventory

$____________ For Leasehold Improvements $____________ For Working Capital

$____________ For Debt Consolidation $____________ For Business Purchase

Please provide details of disbursement such as credit card statements if consolidating debt or equipment

details if purchasing machinery, etc.

Personal Information (Primary Contact)

Last Name: ____________________ First Name: ____________________ Middle Initial: __________

Birth Date: ____________________ SIN #: ____________________ Drivers License #: ____________

Home Telephone: ______________ Cell Phone: _______________ E-Mail: _____________________

Home Address: __________________________________________________________________________

Mailing Address: ________________________________________________________________________

Personal Financial Information (Real Estate)

I own personal real estate located at ___________________________________________that I estimate to

be worth $____________. I owe mortgages against this property in the amount of $____________ leaving

$____________ of equity.

Other names on title include __________________________________________

Please provide a copy of your mortgage statement(s) identifying monthly payment, term, balance, etc.

Personal Financial Information (Vehicles/Equipment/Boats)

I own the following vehicles and equipment:

Year _____ Make __________ Model __________ valued at $_________ and I still owe $_________.



Please provide a copy of registration for each asset and the lease/loan agreement for eachvehicle/equipment/boat financed.


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Personal Financial Information (Credit Cards and Loans)

I have _____ (number) credit cards with a total limit of $__________. The balance owing on my credit cards

is $__________ and my combined monthly payments are $__________.

I have _____ (number) bank/family loans excluding mortgages and vehicle/equipment debt mentioned

above. The balance owing on these loans is $__________ and my combined monthly payments are

$__________.

Please provide a copy of credit card statements, loan agreements, and family notes identifying terms of

repayment and balances owing.

Personal Financial Information (Details)

Has the borrower ever had an asset repossessed? Yes No Date ______________

Has the borrower ever declared for bankruptcy? Yes No Date ______________

Is the borrower party to any claim or lawsuit? Yes No Attach Details

Does the borrower owe any taxes prior to the current year? Yes No Amount $__________

Disclosure and Release Statement

Are you related to any Director or Employee of CF Strathcona? Yes No

The statements made herein are for the express purpose of obtaining financing from Community Futures Strathcona and are to

the best my knowledge true and correct. I understand that additional information must be supplied to Community Futures

Strathcona before adequate consideration can be given.

I consent to Community Futures making any inquiries of such persons, firms or corporations as it deems necessary in order to

reach a decision on this application.

The foregoing information is submitted for the purpose of establishing or maintaining credit with Community Futures Strathcona

and is a true, full and correct statement of my financial condition on the date shown. I hereby authorize Community Futures

Strathcona to obtain any information it deems necessary about me, including but not confined to, reports from credit bureaus,

retail credit companies, or any other source that Community Futures deems appropriate.

I the undersigned, declare that the statements made herein are for the purpose of obtaining business financing and are to the

best of my knowledge complete and correct.

___________________________________ ___________________________________ _________________________

Applicants Signature Printed Name Date

community futures strathcona loan application.pdf

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