Business Prequalification - ANECA Federal Credit Union

Business Prequalification Form

Business Information
Business Legal Name*
Tax ID*
Primary Contact*
First Last
Phone*
Email*
Enter Email Confirm Email
Address*
Street Address Address Line 2 City State ZIP Code
Own or Rent?*
- Own
- Rent
Date Business Established*
Explain Nature of Business*
Loan Request Information
Select all that apply*
- General or Capital Expenditures
- Startup
- Working Capital (specify use below)
- Business Improvements
- Refinance or Debt Consolidation
- Other (please specify below)
- Modification to an existing Credit Union loan (excluding interest rate & fee charge) (please specify below)
- Purchase of an Existing Business
- Purchase of Real Estate
- Purchase of Vehicle (please describe below)
- Purchase of Equipment (please describe below)
- Purchase Price (please specify below)
- Down Payment (please specify below)
You selected "Working Capital" above; please specify use:*
You selected "Other" above; please specify:*
You selected "Modification to an existing Credit Union loan" above; What is the existing Loan Number?*
You selected "Modification to an existing Credit Union loan" above; What is the change requested?*
You selected "Purchase of Vehicle" above; Please describe:*
You selected "Purchase of Equipment" above; Please describe:*
You selected "Purchase Price" above; Please list the price here:*
You selected "Down Payment" above; Please list the down payment here:*
Requested Loan Amount
Please specify the Loan Amount Requested*
Collateral to Secure Your Business Loan
The following information will help us better understand assets being pledged to secure your business loan request(s).
CHECK ONLY the following collateral that is being offered to secure your Small Business loan request(s). Current Value, Lien(s), description, & owner name(s) are required for all pledged collateral.*
- CD
- Savings
- Marketable Securities
- Equipment - New
- Equipment - Used
- Vehicle - New
- Vehicle - Used
- Accounts Receivable
- Inventory
- Owner Occupied Real Estate - Residential
- Owner Occupied Real Estate - Commercial
- Investment Real Estate - Residential
- Investment Real Estate - Commercial
- Investment Real Estate - Mixed Use
- Investment Real Estate - Raw Land
- Investment Real Estate - Other
Collateral - CD - Information Needed
Current Value*
Current Lien(s) (Amount Outstanding/To Whom Payable)*
Describe Collateral (if real estate also provide address)*
Owner Name(s)*
Collateral - Savings - Information Needed
Current Value*
Current Lien(s) (Amount Outstanding/To Whom Payable)*
Describe Collateral (if real estate also provide address)*
Owner Name(s)*
Collateral - Marketable Securities - Information Needed
Current Value*
Current Lien(s) (Amount Outstanding/To Whom Payable)*
Describe Collateral (if real estate also provide address)*
Owner Name(s)*
Collateral - Equipment - New - Information Needed
Current Value*
Current Lien(s) (Amount Outstanding/To Whom Payable)*
Describe Collateral (if real estate also provide address)*
Owner Name(s)*
Collateral - Equipment - Used - Information Needed
Current Value*
Current Lien(s) (Amount Outstanding/To Whom Payable)*
Describe Collateral (if real estate also provide address)*
Owner Name(s)*
Collateral - Vehicle - New - Information Needed
Current Value*
Current Lien(s) (Amount Outstanding/To Whom Payable)*
Describe Collateral (if real estate also provide address)*
Owner Name(s)*
Collateral - Vehicle - Used - Information Needed
Current Value*
Current Lien(s) (Amount Outstanding/To Whom Payable)*
Describe Collateral (if real estate also provide address)*
Owner Name(s)*
Collateral - Accounts Receivable - Information Needed
Current Value*
Current Lien(s) (Amount Outstanding/To Whom Payable)*
Describe Collateral (if real estate also provide address)*
Owner Name(s)*
Collateral - Inventory - Information Needed
Current Value*
Current Lien(s) (Amount Outstanding/To Whom Payable)*
Describe Collateral (if real estate also provide address)*
Owner Name(s)*
Collateral - Owner Occupied Real Estate - Residential - Information Needed
Current Value*
Current Lien(s) (Amount Outstanding/To Whom Payable)*
Describe Collateral (if real estate also provide address)*
Owner Name(s)*
Collateral - Owner Occupied Real Estate - Commercial - Information Needed
Current Value*
Current Lien(s) (Amount Outstanding/To Whom Payable)*
Describe Collateral (if real estate also provide address)*
Owner Name(s)*
Collateral - Investment Real Estate - Residential - Information Needed
Current Value*
Current Lien(s) (Amount Outstanding/To Whom Payable)*
Describe Collateral (if real estate also provide address)*
Owner Name(s)*
Collateral - Investment Real Estate - Commercial - Information Needed
Current Value*
Current Lien(s) (Amount Outstanding/To Whom Payable)*
Describe Collateral (if real estate also provide address)*
Owner Name(s)*
Collateral - Investment Real Estate - Mixed Use - Information Needed
Current Value*
Current Lien(s) (Amount Outstanding/To Whom Payable)*
Describe Collateral (if real estate also provide address)*
Owner Name(s)*
Collateral - Investment Real Estate - Raw Land - Information Needed
Current Value*
Current Lien(s) (Amount Outstanding/To Whom Payable)*
Describe Collateral (if real estate also provide address)*
Owner Name(s)*
Collateral - Investment Real Estate - Other - Information Needed
Current Value*
Current Lien(s) (Amount Outstanding/To Whom Payable)*
Describe Collateral (if real estate also provide address)*
Owner Name(s)*
Disclosure
The undersigned certifies that I intend to apply for Credit in the manner indicated in this application and certify that everything stated in this application and on any attachment is correct. The Lender may keep this application whether or not it is approved. I certify that the credit being applied for will be used for business purposes. My signature also certifies that the information on this application and on all supporting documents is true, that my intent is to apply for business purpose credit in which the use of the proceeds will not be used to secure a dwelling or for home improvements, and that this application is not a commitment to lend. Applicant may be required to submit additional information to process this request for credit. My signature authorizes and requests Lender to share the information provided on this application, together with the results of this investigation of the credit and financial condition of the company and each applicant, with the U.S. Small Business Administration (“SBA”) and/or Business Alliance Financial Services, LLC (“CUSO”) in order to allow the Lender and CUSO to offer the credit product best suite to the company and each of the owner’s/guarantor’s financing needs.
Do you agree to the above disclosure?*
- I agree
Authorized Signer's Information
Name of the Business*
Name of the Authorized Signer*
Prefix First Middle Last Suffix
Authorized Signature*
Today's Date*
MM slash DD slash YYYY

Main Contact:

Jessica Watkins

318-698-6348

Business Loan Documents Needed:

Articles of Organization and Tax ID Form
Operating Agreement
Member Business Loan Application
Business Debt Schedule
Personal Financial Statement, each guarantor
3 Years Business Tax Returns
** If most recent tax return is not available, will need Year-end Financials and Extensions Letter
2019 P&L and Balance Sheet
3 Years Personal Taxes
** If most recent tax return is not available, will need Year-end Financials and Extension Letter
Most recent W-2’s or Paystubs

** If any guarantor has 20% or more ownership in any other business, will need to provide the same documentation for all entities

Business Prequalification Form

Business Information

Loan Request Information

Requested Loan Amount

Collateral to Secure Your Business Loan

Collateral - CD - Information Needed

Collateral - Savings - Information Needed

Collateral - Marketable Securities - Information Needed

Collateral - Equipment - New - Information Needed

Collateral - Equipment - Used - Information Needed

Collateral - Vehicle - New - Information Needed

Collateral - Vehicle - Used - Information Needed

Collateral - Accounts Receivable - Information Needed

Collateral - Inventory - Information Needed

Collateral - Owner Occupied Real Estate - Residential - Information Needed

Collateral - Owner Occupied Real Estate - Commercial - Information Needed

Collateral - Investment Real Estate - Residential - Information Needed

Collateral - Investment Real Estate - Commercial - Information Needed

Collateral - Investment Real Estate - Mixed Use - Information Needed

Collateral - Investment Real Estate - Raw Land - Information Needed

Collateral - Investment Real Estate - Other - Information Needed

Disclosure

Authorized Signer's Information

Main Contact:

Business Loan Documents Needed:

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