Business Loan Application

All materials submitted to CEI in connection with your loan application shall become the property of CEI and shall be retained or destroyed in accordance with CEI's file retention policy.

CEI APPLICATION FOR FINANCING

Loan Amount ($) Requested:

Business Structure:

Sole Prop DBA:

Information About Your Business

Legal Business Name

DBA:

Business Street Address:

City:

State:

Zip Code:

County:

County Name:

Phone:

Website:

Date Established:

IRS Employer ID # (EIN):

Business Description:

Name(s) of any subsidiaries/affiliates:

Information About You

First Name:	Middle Initial:	Last Name:
Phone:	Email:	Street Address:
City:	State:	Zip Code:
County:	County Name:	Are you an owner with ≥ 20% interest in this business? YesNo
Title:	% of Ownership	Annual Salary:

Are you applying with a Co-Applicant or Guarantor?

YesNo

Co-Applicant or Guarantor:

First Name:	Last Name	Phone:
Email:	Street Address:	City:
State:	Zip Code:	County:
County Name:	Are you an owner with ≥ 20% interest in this business? YesNo	Title:
% of Ownership	Annual Salary:

Business Ownership/Leadership*

Additional owner(s) with ≥ 20% interest must submit a personal financial statement and copy of valid photo identification.

Are there any other owners with 20% or greater share of the business?

YesNo

First Name:

Last Name:

Title:

Email:

Street Address:

City:

State:

Zip Code:

County:

County Name:

% of Ownership:

Annual Salary:

Are there any other owners with 20% or greater share of the business?

YesNo

First Name:

Last Name:

Title:

Email:

Street Address:

City:

State:

Zip Code:

County:

County Name:

% of Ownership:

Annual Salary:

* Cooperatives and Nonprofits, please upload a list of board members:

Business Employment and Benefits

# of Current Full Time Employees (incl. self)	# of Current Part Time Employees:
Projected FT staff increase over the next 12 months:	Projected PT staff increase over the next 12 months:
Minimum FT Starting Wage ($/hr):	Minimum PT Starting Wage ($/hr):
Do you offer benefits?	If yes, list benefits here:

Business Development

Name of Advisor:

Hours of Counseling Provided:

How did you hear about CEI?

References:
For personal references please provide the names and contact information for your two nearest relatives, not living with you.

Personal Reference #1:

First Name:

Last Name:

Phone:

Email:

Personal Reference #2:

First Name:

Last Name:

Phone:

Email:

Bank/Trade Reference:

First Name:

Last Name:

Phone:

Email:

Business Locations: Existing or to be Acquired

Property Address:	Owned or Leased?	Sq. Ft:
Monthly Payment:	Replaced by new facility?

Add another business location?

YesNo

Property Address:	Owned or Leased?	Sq. Ft:
Monthly Payment:	Replaced by new facility?

Farmland Acreage Owned:

Farmland Acreage Leased:

Proposed Source(s) of Funds: click add another response to add another planned source of funds

Source Name:

Amount:

Source Type:

Description (if needed):

Proposed Use(s) of Funds: click add another response to add another planned use of funds

Use Type:

Amount:

Description (if needed):

Proposed Collateral: click "add another response" to add another piece of collateral

- Click "add another response" to add another piece of collateral.
- Optionally, attach a complete list of current business assets below this section.

Type of Collateral:

Collateral Description:

Estimated Value:

Balance ($) of Existing Liens/Loans:

Additional Comments:

Upload a list of current business assets here:

Summary of Existing Business Loans and Leases

Creditor:	Creditor Address:	Amount:	Interest Rate: Enter as an integer, i.e. 9.5 = 9.5%
Monthly Payment Amount:	Present Balance:	Origination Date:	Maturity Date:
Type of Collateral Used:	Is it Past Due?

Borrower Questions:

- If you answer yes to any of the following questions, please provide an attachment with details -

Have you or any officers of your company ever been involved in bankruptcy or insolvency proceedings?

Upload a File

Are you or your business involved in any pending lawsuits?

Upload a File

Do you buy from, sell to, or use the services of any entity in which someone in your company has a financial interest of 20% or more?

Upload a File

Have you or your business ever been > 30 days late repaying personal or business debt?

Upload a File

If you owe child support, are you > 60 days late on payment?

Upload a File

Apply Now for Business Loans up to $1 Million

Acknowledgement and Submission