Business Loan Application

Thank you for your interest in First National Bank of Muscatine.  Our general trade area is Muscatine County, Iowa and the surrounding contiguous counties.  We welcome all applications from our designated market area.


Please Choose Credit Type:   Individual Credit (relying on my income or assests)
Joint Credit (will be based upon credit information of both applicants)

 

Commercial Line of Credit 

Rental & Investment Property

Construction Line of Credit

Commercial Loan

Equipment Financing

 

 
1. General Information

Please fill out the following:

Borrower Name    Tax ID# 

Address    

City State Zip Code

Contact Name             

Contact Phone #  Contact Fax #

Contact Email Address:

Contact Title    

2. Ownership/Management Structure
Please choose one form of Management Structure:
 Corporation    General Partnership  Individual/Proprietorship
  Limited Partnership   Limited Liability Company
  Professional Corporation   Other

Please list Key Owners:

Name    Birth Date

Titles 

Name    Birth Date

Titles 

Name    Birth Date

Titles 

Name    Birth Date

Titles 

3. Company History/Profile

Type of Business   How long in business
Full Time Equivalent Employees

4. Description of Proposed Financing

Amount Requested:      Date Needed:

Source of Loan Repayment:

Please check reason for Loan Request (check all that apply)
   Inventory $       Purchase/Refi of Real Estate $ 
   Accounts Receivable $             Purchase of a Business $ 
  Buy-Out of Partner/Shareholder $          Purchase of Equipment $ 
  Other (Please specify)  $  

5. Support Information

  • 3 Years of Financial Statements and Tax Returns for borrower(s)

  • Current Personal Financial Statements and 3 years of tax returns for all principals or guarantors.

  • Receivables Aging, Contract Progress Reports (if applicable)

  • A list of subject inventory, and/or subject equipment with serial numbers (if applicable)

  • A list describing Marketable Securities and number of shares. (if applicable)

  • Sales Contract and/or Purchase Agreement (if applicable)

  • Financial projections and Business Plan (if applicable)

  • Business resolution giving appropriate loan and/or deposit, authority to and naming, individuals authorized by the Business.

Additional Comments (if any)

By signing or submitting this application the applicant(s) specifically acknowledge and agree that: (1) All statements made in this application are made for the purpose of obtaining the loan(s) indicated herein; (2)Verification or re-verification of any information contained in the application may be made at any time by the lender, its agents, successors, and assigns, either directly or through a credit reporting agency, from any source named in this application; (3)The original copy of this application will be retained by the lender, even if the loan is not approved;(4)The Lender, its agents, successors and assigns will rely on the information contained in the application and I/we have a continuing obligation to amend and/or supplement the information provided in this application if any of the material facts which I/we have represented herein should change prior to closing; (5) In the event my/our payments on the loan indicated in this application become delinquent, the lender, it's agents, successors and assigns, may, in addition to all other rights and remedies, report me/our name(s) and account information to a credit reporting agency; (6) ownership of the loan may be transferred to a successor or assign of the Lender without notice to me and/or the administration of the loan account may be transferred to an agent, successor or assign of the Lender with prior notice to me; and (7) that all expenses for legal fees, title examination, appraisal, and settlement or other charges of the loan are to be paid by the borrower.

Certification: I/We certify that the information provided in this application is true and correct as of the date of submission on this application and acknowledge my/our understanding that any intentional or negligent misrepresentation(s) of the information contained in this application may result in civil liability and/or criminal penalties including, but not limited to, fine or imprisonment or both under the provisions of Title 18, United States Code, Section 1001, et seq. and liability for monetary damages to the Lender, its agents, successors and assigns, insurers and any other person who may suffer any loss due to reliance upon any misrepresentation which I/we have made on this application.

Signature

Date

Title (if applicable)

Signature

Date

Title (if applicable)

Signature      

Date

Title (if applicable)

 

Please include copies of applicable corporate minutes and resolution papers with this application.

By submitting this form, I accept that it is legally binding.

REMINDER: If you wish to send your application to us online, we want to remind you that e-mail applications are not necessarily secure against interception.  Applications, by their nature, include personal and confidential information.  Therefore, you may wish to consider printing our application, completing it, and sending it to us via U.S. postal mail.

Once we receive this application we will be in touch with you to follow-up and receive your signature(s).

If you choose to print this application at this time, please select the landscape option in the "Page Setup" function for best viewing.

Federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account in order to help the government fight the funding of terrorism and money laundering activities. This means that when you open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you.  We may also ask to see your driver’s license or other identifying documents.

Update 08/04

 
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300 E. 2nd St. | Muscatine, IA 52761
ph 563-263-4221 | fax 563-262-4213

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