Loan Application

BORROWER’S INFORMATION

Full Name:

Date of Birth (MM/DD/YYYY):

Gender:

Driver’s License:

Home Telephone:

Cellular Phone:

Email Address:

Home Address:

Mailing Address:

Country:

City:

State:

Zip Code:

Marital Status:

Social Security:

Previous Address (if less than 3 years at current address):

Do you rent or own your home:

How long at this address?:

BORROWER’S EMPLOYMENT HISTORY

Current or most recent employer’s name:

Employer’s telephone:

Salary:

How long were you employed/have been employed here:

BUSINESS INFORMATION

Will this business be a start up?

Is this an existing business?

This business have been operating full-time since (if applicable):

This business has been operating part-time since (if applicable):

This business will be a (check one)

This business will be operating in the primary sector of (check one)

Business Number (if obtained):

Incorporation Number (if obtained):

Legal name of business is/will be:

Physical address of business:

City:

State:

Zip Code:

Business Telephone:

Business Fax:

Email:

Website:

Mailing address of business (if different than above):

LOAN INFORMATION

Loan Amount $:

Loan Duration:

Purpose of Loan:

Has the borrower/spouse/common law party ever had an asset repossessed?

Has the borrower/spouse/common law party ever declared bankruptcy?

Is the borrower/spouse/common law party to any claim or lawsuit?

Does the borrower/spouse/common law party owe any taxes prior to the current year?

If YES to any of the above, please provide details:

Does the borrower carry life insurance?

If yes, amount $:

SPOUSE/COMMON LAW INFORMATION (if applicable)

Full Name:

Date of Birth (MM/DD/YYYY):

Gender:

Driver’s License:

Current or most recent employer’s name:

Employer’s telephone:

Salary:

Time employed here:

Note: All information provided in this loan application will be strictly kept confidential between the Lender and the Borrower.

I accept the Terms and Conditions

Your trust and security are our top priorities. We use industry-standard security protocols and best practices to safely handle your information. If you choose to connect a bank account or accounting software with GB Loan Management, LLC., we do not store your login credentials. Getting an offer for a business line of credit and approved loan through GB Loan Management, LLC. will not affect your credit score.

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