Austin CDC Revolving Loan Fund



Loan Fund Application

Date:_____________

Business Name:_______________________________________________________________________________

____________________________________________________________________________________________

(Street address) (City) (State) (Zip code)

Business Phone: ( )_________________Fax: ( )______________ Cell: ( )______________

Tax Identification Number (TIN/EIN) :__________________________________

Email Address: _____________________________ Website Address: ____________________________

Applicant(s)/Owner(s): (if multiple, attach information on all).

Name: _____________________________ TxDL#:_______________ SSN#:______________ Ownership%:_____Title:_________

Name:______________________________ TxDL#:_______________ SSN#:______________ Ownership%:_____Title:_________

Supplemental Contact Information: (Not living in same residence)

Name: _____________________________ Relationship:____________________________

Phone: ( )____________Address:_______________________________________________________________

Business Owner(s): ______Male _____ Female (if more than one, put appropriate amount in each blank)

Ethnicity (optional): _____Asian _____Anglo _____African American _____Hispanic ___ Native American ____Other

(Specify:____________________)

Estimated Loan Request: Working Capital $ ____________

Equipment $ ____________

Real Estate $ ____________

Other $ ____________

Total: $ ____________

Estimated Owner Cash Contribution: $ ____________

I (we) authorize PeopleFund and/or its agents to make any investigations of credit either directly or through any agency which has credit information. I understand that there are normal costs associated with loan underwriting. At a minimum all approved loans are subject to: 1) 2% Origination Fee, 2) $325 Loan Document Preparation Fee, 3) $60 UCC Search/Filing Fee. (This list does not enumerate all fees, only minimal fees. Loans collateralized with vehicles or Real Estate are subject to other standard fees which may be significant). I agree to inform PeopleFund immediately of any matter which may cause significant changes in my financial condition. I allow PeopleFund staff to share my business information with PeopleFund Board and investment committee.

If approved, all PeopleFund clients are required to enroll in auto-debit loan payment withdrawal.

I acknowledge PeopleFund is a federally funded organization and that fraud can be prosecuted as a criminal offense.

Applicant(s) Signature: _______________________ , _______________________ , ____________________

2921 E. 17th Street, Building D, Suite 1 σ Austin, TX 78702 σ (512) 472-8087 σ Fax (512) 472-8191

BUSINESS INFORMATION

Business Structure: ____Proprietorship ____General Partnership ____ Corporation ____S-Corp. ________L.L.C. ________ L.P.___Entity To Be Formed

Years of operation under current ownership: ______years _____new business

Last year’s Revenues: $___________________ Current Revenues: $______________________

What are your average annual expenses? _________

Do you or your company have any tax liens and/or judgments?

Have or your company have any tax liens and/or judgments?

Have you ever filed Bankruptcy? ____ If yes, which type? ___ Ch. 7 ___ Ch. 11 ___ Ch. 13 (Check One)

Date of last Bankruptcy:___________________

Explain:__________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

Are you/your company currently under any litigation?

Explain:

Number of Employees: Current ____Full-time ____Part-time After loan ____Full-time _____Part-time

Primary Business Bank:____________________________ Contact & phone:_________________________

How did you find out about us? Name___________________________ Organization______________________

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