Business Loan Application - Liberty Bell Bank Page 2
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4Loan Request
Amount
Term
Type of Credit *
.
Loan Purpose (please be specific)
.
______________________________________________________________________________
* Line of Credit, Equipment Loan, Term Loan, Commercial Mortgage Loan
Collateral Offered (check as many as appropriate)
( ) General lien on all business assets
( ) Specific Equipment (please list on separate sheet with serial numbers)
( ) Real Estate (please provide copy of latest tax bill)
( ) Personal Assets (please asterisk the items on Personal Financial Statement)
( ) Other ___________________________________________________________________
Guarantors (Personal Financial Statement and full tax return copies must be furnished)
Name
Social Security No.
.
Address
.
Name
Social Security No.
.
Address
.
Name
Social Security No.
.
Address
.
Key Questions
Is the business current on all tax payments? (
) yes (
) no
Is the business an endorser, guarantor or co-maker for any obligation? (
) yes (
) no
Has the business or any principal ever declared bankruptcy? (
) yes (
) no.
Are any business assets presently encumbered? (
) yes (
) no. If yes, provide details.
Is the business a defendant in any lawsuit? (
) yes (
) no. If yes, provide details.
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2099 Route 70 East, Cherry Hill, NJ 08003 <> Phone (856) 830-1165 <> Fax (866) 218-6452
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