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LOAN APPLICATION FORM
CONTACT NAME:
Title:
Company Name:
Street:
City / Town:
Province:
Postal Code:
Tel. No.:
Cell No.:
Fax No.:
Email:
Type of Business:
Start-up
Existing Business
Years in Business:
Status of Business:
Sole Proprietorship
Partnership
Corporation
Industry:
Amount of Financing Requested:
Purpose of Financing:
Equipment Financing
Receivables Financing
Factoring
Working Capital
Business Purchase
Commercial R.E.
Other:
Briefly describe the use of funds:
Personal Guarantees Available:
Yes
No
Personal Credit History of Owners:
Excellent
Satisfactory
Poor
Credit History of Business
Excellent
Satisfactory
Poor
If a Business Purchase: Purchase Price $
Cash Invested by Buyer $
Total Business Assets $
Total Liabilities $
Total Business Net Worth $
Annual Revenue of Company
Annual Profit of Company
How did you hear about this online application?
Burlington, Ontario 905-336-3847
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Hyland Capital © 2008.
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