Owner Information
Name *
First
Middle
Last
Social Security Number *
Date of birth *
/MM
Home Phone # *
/DD
-###
Business Phone # *
-###
-###
Cell Phone *
-###
Email Address *
YYYY
####
-###
-###
####
####
Residence Address *
Street Address
Province / Region
Code
Address Line 2
City
State /
Postal / Zip
Country
Are you employed? *
Yes
No
List the company/position. *
Have you or anyone in your family ever been self-employed? *
Yes
No
Have you ever participated in any Business Advisory or Counseling Services before? *
Yes
No
Highest Level of Education *
High School
Some College
Degree or higher
Are you a U.S. Citizen? *
College Degree
Some Post Graduate
Yes
No
Are you a permanent resident alien? *
Yes
No
Are you presently under indictment, on parole, or probation? *
Graduate
Yes
No
If yes, furnish the details. List name(s) under which held, if applicable. *
Have you ever been charged with or arrested for any criminal offense other than a minor
motor vehicle violation? *
Yes
No
If yes, furnish the details. List name(s) under which held, if applicable. *
Is there a co-applicant?
Yes
No
Co-Applicant Information
Co-Applicant Name *
First
Phone *
-###
-###
Co-Applicant's Email *
Last
####
Co-Applicant Residence Address *
Street Address
Province / Region
Code
Address Line 2
City
State /
Postal / Zip
Country
Co-Applicant Social Security # *
Co-Applicant Date of Birth *
/MM
/DD
YYYY
Company Information
Company Name *
Primary Business Address *
Street Address
Address Line 2
Province / Region
Code
City
State /
Postal / Zip
Country
Principal in charge *
First
Work Phone
-###
Cell Phone
Fax
Email
-###
-###
-###
Last
####
-###
-###
####
####
Business Industry
Type of entity (check one) *
Proprietorship
Partnership
What year did the business start? *
LLC
Corporation
Number of current employees *
Company Ownership
Please list primary owners of the company. (Anyone owning 20% or more.)
Name *
Title *
First
Last
Percent of ownership *
Name
First
Last
Title
Percent of ownership
Name
Title
First
Last
Percent of ownership
Name
Title
First
Last
Percent of ownership
Affiliate Businesses
List any other businesses of owner(s)/guarantor(s).
Business name
Owner name
Business name
First
Last
Owner name
Business name
First
Last
Owner name
First
Last
Operating Company Profile
Tell us about your company.
Describe your business and the products or services you offer. *
What is your primary market and who are your target customers? *
List your major competitors, suppliers, and your future plans. *
Have you or an officer in your company ever been involved in bankruptcy or insolvency
proceedings?*
Yes
No
If yes, provide more information. *
Are you or your company involved in any pending lawsuits? *
Yes
No
Do you conduct business with any relative(s)? *
Yes
No
Do you conduct business with any vendor(s) for which someone in your company has a
significant financial interest? *
Yes
No
If yes to either of the above, provide more information. *
New Project Information
Physical address of project *
Street Address
Province / Region
Code
Address Line 2
City
State /
Postal / Zip
Country
Project costs
Acquisition and/or repair of machinery and equipment$
Inventory Purchase$
Working capital$
.Dollars
.Dollars
Acquisition of an existing business$
Real Estate (land and building)$
.Dollars
Cents
Cents
Cents
.Dollars
.Dollars
Cents
Cents
New construction/expansion/repair/leasehold improvement$
What is the square footage of the new building/leasehold space?
What is the square footage your company will occupy?
Other$
.Dollars
Cents
Please describe Other (listed above)
Total project cost *$
.Dollars
Cents
Will this loan create new employment opportunities? *
.Dollars
Cents
Yes
No
Estimated number of new employees within the next two years as a result of this loan.
References
Bank or Credit Union name *
Account officer *
Phone
-###
First
-###
Last
####
Referral Source
How did you hear about ACE?
How did you hear about us? *
If you were referred by a bank, please tell us which bank and whom referred you.
Personal Information
Indicate gender *
Male
Female
I prefer not to answer.
With which race do you more closely identify? *
Black or African American
Asian
American Indian or Alaskan Native
Native Hawaiian or Other Pacific Islander
With which ethnicity do you identify? *
Not Hispanic or Latino
Are you a veteran? *
Hispanic or Latino
I prefer not to answer
I prefer not to answer
Yes
No
If yes, what branch?
Credit Report Authorization
I declare that the information provided in this application is true and correct. I hearby
authorize the release of any and all credit report and other information required in the
White
processing of my loan application and as required in the servicing and/or during the term of
my loan. I further authorize ACE and its successor to release such information to any entity
as required in the processing of my loan application.
I/we hereby certify that the enclosed information, including any attachments or exhibits
provided herwithin or at a later date, is valid and correct to the best of my/our knowledge.
Signature of applicant *
_______________________
Signature of co-applicant (if applicable)
________________________
If we take adverse action on your application for credit, you have the right to a statement of
specific reasons as to why we took such adverse action within 30 days if you request the
statement within 60 days of our notification. You may contact [the name, address, and telephone
number of the person or office at ACE] to obtain the statement of reasons. The Federal Equal
Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the
basis of race, color, religion, national origin, sex, marital status, age (provided the applicant has
the capacity to enter into a binding contract); because all or part of the applicant's income derives
from any public assistance program; or because the applicant has in good faith exercised any
right under the Consumer Credit Protection Act. The Federal Trade Commission, Equal Credit
Opportunity, Washington, DC 20580 administers ACE's compliance with the Equal Credit
Opportunity Act.