Loan Application (Page 4 of 4) in pdf

_________________________________________________________________________________________________________________________________

IV. BUSINESS INFORMATION

Legal Entity Name: ____________________________________ D.B.A. ____________________________________

Type of Industry: _________________________________________________________________________________

Entity form: ☐ LLC ☐ Corp. ☐ S-Corp. ☐ Sole Prop.

Professional Title: ☐ President ☐ VP ☐ Treasurer ☐ COO ☐ CEO ☐ CFO ☐ GM

Projected Income / Sales: ☐ 100K-150K ☐ 151K-200K ☐ 201K-500K ☐ 501K-1M ☐ 1M+ Annual

Physical Address: __________________________________________________________

City: ____________________________________ State: ________ Zip: ______________

Mailing Address: __________________________________________________________

(If different from above)

City: ____________________________________ State: ________ Zip: ______________

Business Phone: _____________________________ Fax: __________________________

EIN #: _____________________________________

Years in Profession: _____________ Number of Employees: ___________

Open Credit Cards:

Financial Institution

Type of Credit Card

Limit / Balance

Years Open

Amount of Funding Needed: $_______________________________________

Please briefly explain how you plan on using your funding for your business:

________________________________________________________________________________________________

I hereby certify that the information contained herein is complete and accurate. By submitting my credit report and signing this form I am giving

consent for Orange Financial to utilize my personal information for the purpose of credit consulting with the understanding that it is to be used to

determine the amount and conditions of the credit to be extended.

Signature: ________________________________

Name: ___________________________________

Date: ____________________________________

Please email your completed application to or fax to 305-434-4651

Orange Financial LLC

1911 NW Miami Court. Miami, FL. 33136

(800) 253-1663

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Loan Application Page 4