Equinoxcapitalpartners.com



BUSINESS EXPANSION LOAN APPLICATION

Please provide all requested documents/information.

Email: drakes@

|Legal Business Name |      |

|Business Address |      |

|City, State, Zip |      |

| |      |

|Phone Number: | |

|All Principal (s) (Guarantors) name(s) |           |

|All Principal (s) (Guarantors) address |      |

|City, State, Zip |      |

|All Principal(s) Guarantor(s) Office Number (s): |      |

| |      |

|Cell Phone Number: | |

|All Principal (s) (Guarantors) Social Security Number (s): |      |

| All Principal(s)(Guarantor’s) email/ address: |      |

|Does Principal (s) (Guarantor(s) have |           |

|any outstanding federal debt? | |

|Does Principal (s) (Guarantor(s) have any contingent liabilities? If |      |

|yes, give details: | |

|Does any Principal (s) Guarantor(s) have any judgments, liens, |      |

|bankruptcies, foreclosures? | |

|Nature of Business |      |

|Years in business and/or industry |      |

|Federal Tax ID/EIN |      |

|Ownership Structure: LLC, Corporation, Partnership, etc. |      |

|Gross Annual Sales/Revenues ($) |      |

|Net Business Income ($) |      |

| Amount of Financing Requested ($) |      |

|Briefly describe purpose of loan: |      |

You must submit the following items with this Application:

▪ Executive summary/Business Plan

▪ Personal financial statement dated within 30 days;

- All Principals with 20% or more ownership must, each, complete a

Personal Financial Statement

▪ 3 Years P & L Statements & Current Year to Date P & L Statement

Your signature below is: (i) your Company’s application information through you as its authorized signe r for the review proc ess; (ii) your agree ment to the terms and your representation that the questions in this form have been answered fully and truthfully; (iii) you and your Company ’s agree me nt as applic able to the Agree me nts and Re prese ntations section below, and; (iv) you and your company’s understanding that Equinox Capital Partners and or its assignees, Lenders or representatives have no obligation to proceed unless it approves the contents of this c ompleted form.

AGREEMENTS AND REPRESE NTATIONS

1. You and Company represent to Equinox Capital Partners and its assignees, Lenders or representatives that all information provided on this application or otherwise in connection with the project is true and correct, is not misleading, and does not contain any material omissions.

2. Company agrees to all of the terms and c onditions applicable to the review process and the requests thereof.

3. You authorize us to obtain consumer reports on each of you from Consume r Reporting Agencies in considering the project and in connection with any financing procedures to the Company or review or further collection of any information gathered by this application. We may obtain business reports (Westlaw Background Search(s) on Company.

4. You represent to Equinox Capital Partners and its assignees, lenders or representatives -that each of you are authorized to sign this application on behalf of Company, that each of you have the title indic ated and that no other person(s) is/are required to sign this form in order to bind the Company or to ma ke any of the representations, agree ments, or other information in this application accurate, effective and legally binding.

All owners and other principal representatives must sign this form. If there are more than four signers, please c opy this form, c omplete and sign this sec tion, and attach the c opy to this form.

Guarantor/Title Date ___________

Guarantor/Title __________________ Date

Guarantor/Title ____________________ Date

Guarantor/Title _____________________ Date

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