Finance Centre > Application Form > Finance Form ( DNN 3.2.2 )

Application for:

Business Finance

Commercial Property Finance

Please fill-in all the fields. Mark ‘N/A’ wherever not applicable.

Name in full: Mr./Mrs./Ms.

Age: (yrs)

Bus. title:

Business name:

In business for (years)

Capital invested: $

Business Type:

Sole Prop.

Partnership

Corporation

Tel.# Bus.:

Res.:

Address:

Convenient time to call: Bus.:

Convenient time to call: Res

Email:

Fax #:

Any bankruptcy declared during the past 7 yrs. – Personal or business?

Yes

No

If yes, give brief details below.

Credit status?

Excellent

Good

Fair

Poor

Tell you later

Don’t know

Amount & time: a) Amount Required: $

b) When required? $

Purpose of finance and how the funds will be used?

How long required and mode of repayment?

Description of property and site/location :

Purchase Price or Original cost of property: $

New

Yes

No

If not new yrs. old

Purchased on: $

Purchase/Original Cost $

+ Improvements to property $

= Total cost $

Property appraised by:

on:

Value: $

Any further improvements required to property?

Property insurance details

Colour photos of the property:

Available & will be sent on request.

Lease summary / Rent roll details:

Existing lender, amt. o/s, rates, term & other related info:

Do you have? a) A business plan

Yes

No

b) Budget

Yes

No

c) Financial statements

Yes

No

Current Year To Date (YTD) operating statement:

Available & will be sent on request.

Unavailable.

Past 3 years historical operating statements:

Available & will be sent on request.

Unavailable.

Short resume / background of the borrower/s:

Any other matter / info:

The above information is true to the best of my knowledge. I fully understand and agree to Finance Centre, Canada, using this information freely and without any obligation or commitment on their part, for trying to obtain the finance requested herein.