Business Application

  Request for Finance  
  Your Name: Your Email: Your Telephone Number: Your Company Name:  
   
  Amount of Loan required: Loan Term: Purpose of Loan: Repayment Proposal:  
   
  Business Details
  Full name of applicant
(legal business entity)		 Business Structure:   Date of Incorporation:  
   
  ACN: Date Business Name registered ABN: Business Ownership:  
 

 
  Full Name: Position: (eg Director) Ownership %    
     
     
     
  Business Trading Address: Postcode: Postal Address: Postcode  
   
  Phone Fax Email    
     
  Main business activity and brief history:      
 
     
 
  Summary of Business Financial Position      
           
  Balance Sheet  
  Details as at: Current Assets Current Liabilities Non Current Assets  
   
  Non Current Liabilities Fixed Assets Total Liabilities Intangible Assets  
   
  Total Assets Equity      
       
  Schedule of existing commitments      
    Commitment 1 Commitment 2 Commitment 3  
  Type  
  Lender  
  Balance  
  Repayments  
  Expiry  
 
  Loan Security
   
  Mortgage Security
 
  Address of Property being offered: Description of building   Lot  
   
  Plan No: Tenancy details
(who, term, rental etc)		 Estimated Value Real property Description  
     
 
  Mortgages
  Name of Lender  
  Amount Owing  
  Contact Name  
  Mortgage Over Business Assets      
  Plant & Equipment Stock – Raw Materials Finished Goods Trade Debtors
(ex + 90 days)		  
   
  Work In Progress:        
         
  Guarantee Security
  Proposed Guarantors
  Full Name  
  Relationship to Applicant  
  Amount of Guarantee  
  Other Security Offered
  Other Security 1 Other Security 2      
     
  Business Owner/Director
  Full Name: Home Address:  Postcode: Previous Address
(if  above is less then 3 years):		  
   
  Postcode: Licence No: Phone (h): Email:   
   
  D.O.B: Phone (w): Phone (m):     
   
 
  Financial Position      
  ASSETS
  Real Estate Assets
  Address Jointly owned with Address  
   
  Personal Effects
  Furniture & effects
(insured value)		 Jewellery
(insured value)		    
     
  Accounts (Bank,Credit Union,Build Soc.etc)
  Organisation Total Balance    
     
  Motor Vehicles
  Model 1 Model 2 Make 1 Make 2  
   
  Investments (shares unit trusts etc)
  Superannuation Other assets TOTAL ASSETS (A)    
     
  LIABILITIES
  Mortgages
  Name of Lender Name of Lender Notes    
     
  Credit /Store Cards
  Card Type Issuer Cr Limit    
     
  Other Loans ( personal/car loans, finance company)
  Lender Type Other debts TOTAL LIABILITIES (B)  
   
           
     
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