Saginaw Economic Development Corporation ● 1315 S. Washington Avenue, Room 110. Saginaw, MI 48601 ● (989) 759-1395 1 of 6 BUSINESS LOAN APPLICATION Each application is subject to a $250.00 non-refundable application fee Note: Application Fee for SEDC Micro Loan is $150 and is non-refundable. Date of Application: Received by Staff: BUSINESS INFORMATION Name of Borrowing Entity / Business: Address of Business: City / State / Zip Code: Phone Number: Fax Number: Business Email Address: Business Website: DUNS Number: EIN Number: CONTACT NUMBER Contact Person: Home Address: Home Phone Number: Cellphone Number: Email Address: STAFF ONLY
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Saginaw Economic Development Corporation ● 1315 S. Washington Avenue, Room 110. Saginaw, MI 48601 ● (989) 759-1395 1 of 6
BUSINESS LOAN APPLICATIONEach application is subject to a $250.00 non-refundable application fee Note: Application Fee for SEDC Micro Loan is $150 and is non-refundable.
Date of Application: Received by Staff:
BUSINESS INFORMATION
Name of Borrowing Entity / Business:
Address of Business:
City / State / Zip Code:
Phone Number:
Fax Number:
Business Email Address:
Business Website:
DUNS Number:
EIN Number:
CONTACT NUMBER
Contact Person:
Home Address:
Home Phone Number:
Cellphone Number:
Email Address:
STAFF ONLY
Saginaw Economic Development Corporation ● 1315 S. Washington Avenue, Room 110. Saginaw, MI 48601 ● (989) 759-1395 2 of 6
List names of all owners, officers, directors, or partners (100% of ownership must be identified):
Name (First, Middle, Last) Title Annual Comp.
Ownership Percentage
Personal Guaranty Offered?
Insurance Carried for Benefit of Applicant?
1 $ %
2 $ %
3 $ %
TYPE OF ORGANIZATION
Sole Proprietorship
Partnership
Corporation
Limited Liability Corporation
S Corporation
Other: ______________________________
BUSINESS QUESTIONNAIRE
This business is… New Existing Purchased as Existing
How long has this business been in operation? years months
Current number of employees:
How many jobs will this loan create?
# of FT: # of PT:
# of FT: # of PT:
What type of business?
Years of experience?
Have you consulted the City’s Zoning Department on this project? • Yes • No
Have you consulted the Saginaw County Health Department on this project (if applicable)?
• Yes • No
Has the applicant, any partner, stockholder, officer, affiliate, owner, or any other person(s) within the business been connected with or have any past due taxes? (This included but is not limited to: Federal withholding taxes, Social Security Taxes, Personal Income Taxes, Corporate Income Taxes, State Sales and Use Taxes, Single Business Tax, Property Taxes, etc.) If yes, provide name and details on separate attachment or in Supplemental Information section on the last page.
• Yes • No
Saginaw Economic Development Corporation ● 1315 S. Washington Avenue, Room 110. Saginaw, MI 48601 ● (989) 759-1395 3 of 6
PROJECT INFORMATION Please tell us about your project and/or start-up budget.
Use of Funds* Sources of Funds
Land and/or Building Purchase $
Loan Requested $
Machinery $
Equipment $
10% Owner’s Investment $
Inventory $
Furniture/fixtures $
Other Funding Sources $
Other (Working Capital not eligible) $
Total Project Uses $
Totals should equal
Total Project Sources $
*Must provide quotations from vendors, dealers, or manufacturers indicating price.
COLLATERAL
Asset Description Cost Value of
Asset Loan on Asset Address of Asset
Property 1 $ $ $
Property 2 $ $ $
Inventory $ $ $
Equipment $ $ $
Furniture/fixtures $ $ $
Accounts Receivable $ $ $
Other (specify) $ $ $
Total $ $ $
Name(s) of Possible Co-Signer(s) for Loan Request:
Saginaw Economic Development Corporation ● 1315 S. Washington Avenue, Room 110. Saginaw, MI 48601 ● (989) 759-1395 4 of 6
OTHER INFORMATION
Participating Bank (1):
Participating Bank (2):
Contact Person:
Contact Person:
Phone Number:
Phone Number:
Accountant:
Legal Counsel:
Contact Person:
Contact Person:
Phone Number:
Phone Number:
Receivership / Bankruptcy: Has applicant or any officers of the applicant or any affiliates or any other concern with which such officer has been connected with ever been in receivership or adjudicated a bankruptcy?
Yes No If yes, answer the following questions:
Which did you file? Chapter 7 Chapter 13
Has it been discharged? Yes No
If yes, when?
Are you related to or do you have business dealing with any City of Saginaw Council Members, SEDC Board of Directors, employees, agents, consultants, or officers of the City of Saginaw? (Failure to disclose this information may result in being disqualified for consideration for a loan through SEDC.)
Yes No If yes, provide name and details on separate attachment or in Supplemental Information section on the last page.
(I) or (We) certify that the information contained in the application and in other supported documents is true andaccurate. Any other use of SEDC funds than requested constitutes fraud. In consideration for accepting thisapplication, the undersigned hereby authorizes the SEDC to seek and obtain from whatever sources necessary,information needed to evaluate the credit worthiness of the applicant and the business for which the loan is beingrequested.
Penalty for false or fraudulent statement: U.S.C. Title 18, Sec. 1001, provides: “Whoever, in any matter within the jurisdiction of any department or agency of the United States knowingly and willfully falsifies or makes any false, fictitious or fraudulent statements or representation or makes or used and false writing document knowing the same to contain any false, fictitious or fraudulent statement or entry, shall be fined not more than $10,000 or be imprisoned not more than five years, or both.”
Saginaw Economic Development Corporation ● 1315 S. Washington Avenue, Room 110. Saginaw, MI 48601 ● (989) 759-1395 5 of 6
SIGNATURE OF APPLICANT(S)
x x Signature Signature
Printed Name Printed Name
All applicants must submit the following additional information or indicate when the following will be obtained and submitted to SEDC (use the Supplemental Information section on the last page to do this.)
You must check the documents included with your application below:
A full listing of products and/or services that will be sold by your business, and a corresponding pricingschedule.
Articles of Incorporation or other documentation of legal identity.
Corporate By-Law Resolution giving you authority of officer signing application to borrow funds.
Copy of Current Lease (if applicable.)
Copy of Proposed Lease (if you are moving to a new leased location) or Letter from Landlord outliningproposed terms (if applicable.)
Description of any present or pending lawsuits involving your business or its owners (if applicable.)
Description of bankruptcy or insolvency, proceedings involving the business or the owners individually (ifapplicable.)
Description of Past Due Taxes, Tax Liens, Tax Levies (if applicable.)
License to do Business.
Market Studies, indicating the sales potential of your products and/or services.
$250.00 Non-refundable application fee ($150.00 for Micro Loan Program.)
Purchase Agreement with Addendums (if applicable.)
Resume of each principal including three (3) references, two (2) business- if new business: three (3)personal.
Schedule of Liability Insurance.
Site Description / Location Demographics (Available from your commercial property manager or realestate agent.)
