Small Business Loan Application Template Page 12
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12Authorization and Notice of Intent
I request Meadows Bank to use the information provided in this questionnaire and any included exhibits to evaluate this request for a
Small Business Loan. I believe the information in this package to be true and accurate. The undersigned authorizes Meadows Bank to
make all inquiries it deems necessary to verify the accuracy of the information provided herein, and to determine my/our credit-
worthiness. (All owners and guarantors must sign this form. Spouses should sign when applicable.)
_____________________________________ ________________________________________________ ____________________________ ___________________
Name
Signature
Title
Date
_____________________________________ ________________________________________________ ____________________________ ___________________
Name
Signature
Title
Date
_____________________________________ ________________________________________________ ____________________________ ___________________
Name
Signature
Title
Date
AUTHORIZATION TO FILE FINANCING STATEMENT
Applicant herby authorizes Lender to fle the appropriate Financing Statements for the following collateral prior to executing a security
agreement, pledge, or control agreement:
____________________________________________________________________ ______________
____________________________________________________________________ _____________
Applicant
Date
Co-Applicant
Date
REGULATION B-NOTICE OF INTENT TO APPLY FOR JOINT CREDIT
Regulation B and the Equal Credit Opportunity Act requires that a lender obtain evidence of each loan applicant's intent to apply for
joint credit. Failure to complete this information when required may render the application / request for credit incomplete. Each
applicant, co-applicant, borrower, joint borrower, co-maker, guarantor is referred to below as “applicant”.
Each of the undersigned intend to apply for joint credit.
Each of the undersigned Applicants acknowledges receipt of a copy of this notice on Today's Date.
INDIVIDUAL APPLICANTS
_____________________________________________________ X________________________________________________________ _____________________
Print or Type Individual Name
Applicant Signature
Today's Date
_____________________________________________________ X________________________________________________________ _____________________
Print or Type Individual Name
Applicant Signature
Today's Date
_____________________________________________________ X________________________________________________________ _____________________
Print or Type Individual Name
Applicant Signature
Today's Date
ENTITY APPLICANTS
____________________________________________________ X________________________________________________________ ______________________
Print or Type Entity Applicant Name
Applicant Signature, Its__________________
Today's Date
____________________________________________________ X________________________________________________________ ______________________
Print or Type Entity Applicant Name
Applicant Signature, Its__________________
Today's Date
____________________________________________________ X________________________________________________________ ______________________
Print or Type Entity Applicant Name
Applicant Signature, Its__________________
Today's Date
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