COMMERCIAL LOAN APPLICATION CHECKLIST · COMMERCIAL LOAN APPLICATION CHECKLIST Thank you for considering Apple Federal Credit Union for your business financing request. Please use

P.O. Box 1208, Fairfax, VA 22038-1208 703-788-4800 Fax: 703-802-4508AppleFCU.org

COMMERCIAL LOAN APPLICATION CHECKLIST

Thank you for considering Apple Federal Credit Union for your business financing request. Please use the following checklist to provide information needed to complete your loan application.

If you have any questions, please contact Commercial Services 703-788-4800 or email [email protected].

General Information

F Commercial Loan Application (attached)

F Personal Financial Statement for each guarantor (attached)

F Beneficial Owner of Legal Entity Customers (attached)

F IRS Form 4506-T for the business and each guarantor (attached)

F Copies of Driver’s Licenses for all owners/signers and guarantors (or Passport Information for Non-US Persons)

Business Financial Information

F Last 3 Years of Federal Income Tax Returns including all schedules, statements and K-1’s if applicable

F Last 3 Years of Fiscal Year End Financial Statements

F Business Plan & Pro-Forma/Projections (if business is new or in operation less than 3 years)

F Interim Financial Statements (within 60 days)

F Current Accounts Receivable and Accounts Payable schedules (if applicable)

F Executed Purchase Agreement (if applicable)

F Rent Roll and Real Estate Operating Statement (if applicable)

F Executed Leases/Rental Agreements (if applicable)

F Executed Purchase Order (for new equipment)

F Executed Construction Contract or Bid for leasehold improvements (if applicable)

F Last 3 months of business checking/saving/investment accounts statements

Business Entity Information

F Certificate of Legal Entity

F Articles of Incorporation/Partnership/Organization/Formation

F Bylaws, Operating/Partnership Agreement and any amendment if applicable

F EIN letter from IRS

F Names of any DBA’s (Doing Business As)

F Business License (if applicable)


Business Name Date (MM/DD/YYYY)

Business Activity TIN #

Address: Street City State Zip Code Phone No.

Mailing Address: Street City State Zip Code(if different frombusiness address)

Are you an Apple FCU Member

F Yes F No

Email/Web Address Fax No.

Legal Structure:

F Proprietorship F Partnership F Corporation F Limited Liability Co. F Other

Are There Affiliates/Related Parties?

F Yes F No

State of Organization: Counties Of Operation: Date Business Started (MM/DD/YYYY) Under Current Management Since?

Principal(s) / Authorized Officer

Title(s)Ownership

% Social Security Number Date of Birth (MM/DD/YYYY)Full Name Address

The Loan Request(s):

Business Loan Puropse(s):

Assets Being Acquired:(Attach Purchase / Sales Agreement) Seller:

Cost:(Excluding Taxes and Shipping)

Down Payment:(Indicate if Cash or Trade)

Loan Amount Requested:(Amount you are Looking to Borrow)

Other Security / Collateral:

COMMERCIAL LOAN APPLICATION

Primary Source of Repayment

Other Sources Of Repayment:

I / We the undersigned, authorize Apple Federal Credit union to perform a credit investigation and / or obtain a credit report from a Consumer Reporting Agency. upon written request, the nature and scope of this investigation, if one is made, will be disclosed to me/us. i / we represent, warrant and affirm that all of the statements made by me/us in this application are true and correct and have been made by me / us to induce you to grant this loan with knowledge that you will rely thereon. it is agreed that this application and credit information is for the sole use of the Credit Union and shall remain their property whether or not the loan is granted. i hereby acknowledge that i have received a copy of this credit application.

Signature

Title Date (MM/DD/YYYY)

Signature


Signature


Signature


EQUAL CREDIT OPPORTUNITIES ACT DISCLOSURE NOTICE

If your business had gross revenues of $1,000,000 or less in the previous fiscal year and the loan for which you have applied is not granted, you have the right within 60-days of receiving the credit union’s notification of your denial, to request a written statement detailing the specific reasons why your request was de-nied. Your request should be directed to Apple Federal Credit Union 4097 Monument Corner Drive, Fairfax, VA 22030.You should know that: 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 Agency that administers compliance with the loan is the National Credit Union Administration: 1775 Duke Street, Alexandria, VA 22314-3428.

This application further requires the submission of the following highlighted items; and will not be considered complete until such documentation is provided :

F Complete questionnaire

F Provide formal business plan

F Submission of additional financial information

CREDIT UNION USE ONLY

APPLICABLE REGULATIONS: ACTION:

F C: (HMDA) Requires Completion Of Separate Worksheet

F Approved & Closed F Applicant Notified Verbally

F X: (RESPA) Requires Completion Of Separate Worksheet

F Denied F Applicant Notified In Writing

F Flood Certification Requires Completion Of Separate Worksheet

F Request Withdrawn By Applicant Date Of Action (MM/DD/YYYY)

COMMERCIAL LOAN APPLICATION (con’t)


PERSONAL FINANCIAL STATEMENT

Financial Statement as of (MM/DD/YYYY):

Submitted To:

PERSONAL INFORMATION

Applicant Name: First MI Last Suffix Co-Applicant Name: First MI Last Suffix

Address: Street City State Zip Code Address: Street City State Zip Code

Home Phone No. Work Phone No. Home Phone No. Work Phone No.

Social Security No. (or ITIN) Date of Birth (MM/DD/YYYY) Social Security No. (or ITIN) Date of Birth (MM/DD/YYYY)

Email Address Marital Status

F Unmarried F Married F Divorced

Email Address Marital Status

F Unmarried F Married F Divorced

Name of Employer Name of Employer

Employer Address: Street City State Zip Code Employer Address: Street City State Zip Code

Position/Title Since Position/Title Since

Previous Employer Previous Employer

Position/Title Since Position/Title Since

Name of Accountant Accountant Phone No. Name of Accountant Accountant Phone No.

Name of Attorney Attorney Phone No. Name of Attorney Attorney Phone No.

Name of Investment Advisor/Broker Investment Advisor/Broker Phone No. Name of Investment Advisor/Broker Investment Advisor/Broker Phone No.

Name of Insurance Advisor Insurance Advisor Phone No. Name of Insurance Advisor Insurance Advisor Phone No.

INCOME & EXPENDITURES STATEMENT FOR YEAR END _____________________ (omit cents)

ANNUAL INCOME AMOUNT ($) ANNUAL EXPENDITURES AMOUNT ($)

Applicant Salary Federal Income and Other Taxes

Co-Applicant Salary State Income and Other Taxes

Applicant Bonuses & Commissions Rental Payments, Co-op or Condo Maintenance

Co-Applicant Bonuses & Commissions Mortgage Payments/Residential

Rental Income Mortgage Payments/Investment

Interest Income Property Taxes/Residential

Dividend Income Property Taxes/Investment

Capital Gaines Interest & Principal Payments on Loans

Partnership Income Insurance

Other Investment Income Investments (Including Tax Shelters)

Other Income (List)** Alimony/Child Support

Tuition

Other Living Expenses

Medical Expenses

Other Expense (List)

TOTAL INCOME TOTAL EXPENDITURES

Any significant changes expected in the next 12 months? F Yes F No (If yes, attach information).

** Income from alimony, child support, or separate maintenance income need not be revealed if the applicant or Co-Applicant does not wish to have it considered as a basis for repaying this obligation.

BALANCE SHEET AS OF (MM/DD/YYYY) ___________________________ASSETS AMOUNT LIABILITIES AMOUNT

Cash in this Credit Union (including Money Market Accounts, CDs) Notes Payable to this Credit Union

Cash in Other Financial Institutions (List including Money Market Accounts, CDs)

Secured

Unsecured

Notes Payable to Others (Schedule E)

Secured

Unsecured

Readily Marketable Securities (Schedule A) Accounts Payable (Attache Schedule)

Non-Readily Marketable Securities (Schedule A) Margin Accounts

Accounts and Notes Receivable (Attach Schedule) Notes Due: Partnership (Schedule D)

Net Cash Surrender Value of Life Insurance (Schedule B) Taxes Payable

Real Estate (Schedule C) Mortgage Debt (Schedule C)

Equipment (Schedule C) Life Insurance Loans (Schedule B)

Affiliate Relationships& Interests (Attach Schedule) Other Liabilities (List):

Vehicles

Furniture & Fixtures

Other Fixed Assets

Intangibles

TOTAL LIABILITIES

TOTAL ASSETS NET WORTH

PERSONAL FINANCIAL STATEMENT (con’t)

CONTINGENT LIABILITIES YES NO AMOUNT

Are you a guarantor, co-maker, or endorser for any debt of an individual, corporation or partnership? F F

Do you have any outstanding letters of credit or surety bonds? F F

Are there any suits or legal actions pending against you? F F

Are you contingently liable on any lease or contract? F F

Are any of your tax obligations past due? F F

What would be your total estimated tax liability if you were to sell your major assets? F F

If yes for any of the above, give details:

SCHEDULE A -- ALL SECURITIES (Including non-Money Market Mutual Funds)

NO. OF SHARES (STOCK)

DESCRIPTION OWNER(S) WHERE HELD COSTCURRENT MARKET

VALUEPLEDGED

YES NO

READILY MARKETABLE SECURITIES (including U.S. Governments and Municipals) *

F F

F F

F F

NON-READILY MARKETABLE SECURITIES (closely held, thinly traded, or restricted stock)

F F

F F

F F

* If not enough space, attach a separate schedule of brokerage statement and enter totals only.

SCHEDULE B -- INSURANCE LIFE INSURANCE (Use additional sheet if necessary)

INSURANCE COMPANY

FACE AMOUNT OF POLICY

TYPE OF POLICY BENEFICIARYCASH SURRENDER

VALUEAMOUNT

BORROWEDOWNERSHIP

DISABILITY INSURANCE APPLICANT CO-APPLICANT

Monthly Distribution if Disabled

Number of Years Covered


SCHEDULE C – PERSONAL RESIDENCE & REAL ESTATE INVESTMENTS, MORTGAGE DEBT (majority ownership only)

PERSONAL RESIDENCE PROPERTY ADDRESS

OWNERPURCHASE

YEAR / PRICEMARKET VALUE

PRESENT LOAN BALANCE

INTEREST RATE

MATURITY DATE

MONTHLY PAYMENT

LENDER

INVESTMENT PROPERTY ADDRESS

LEGAL OWNERPURCHASE

YEAR / PRICEMARKET VALUE

PRESENT LOAN BALANCE

INTEREST RATE

MATURITY DATE

MONTHLY PAYMENT

LENDER

SCHEDULE D – PARTNERSHIPS (Less than majority ownership for real estate partnerships.) *

TYPE OF INVESTMENTDATE OF INITIAL

INVESTMENTCOST PERCENT OWNED

CURRENT MARKET VALUE

BALANCE DUE ON PART-NERSHIPS:

NOTES, CASH CALL

FINAL CONTRIBUTION DATE

Business/Professional (indicate name ):

Investments (including Tax Shelters):

DUE TO TYPE OF FACILITY AMOUNT OF LINESECUREDYES NO

COLLATERALINTEREST

RATEMATURITY

UNPAIDBALANCE

Notes Payable

* Note: For investments which represent a material portion of your total assets, please include relevant financial statements or tax returns, or in the case of partnership investments or S-co S-Corporations, schedule K-1s.


PLEASE ANSWER THE FOLLOWING QUESTIONS:

1. Income tax returns filed through (date): ______________ Are any returns currently being audited or contested? F Yes F No

If yes, what year(s)? _________________________________________________________________________________________________

2. Have (either of ) you or any firm in which you were a major owner ever declared bankruptcy? F Yes F No

If yes, please provide details: __________________________________________________________________________________________

3. Have you drawn a will? F Yes F No

If yes, please furnish the name of the executor(s) and year will was drawn: ______________________________________________________

4. Number of dependents (excluding self ) and relationship to applicant: _________________________________________________________

_________________________________________________________________________________________________________________

5. Have you ever had a financial plan prepared for you? F Yes F No

6. Did you include three years federal and state tax returns? F Yes F No

7. Do (either of ) you have a line of credit or unused credit facility at any other institution(s)? F Yes F No

If so, please indicate where, how much, and name of banker: ________________________________________________________________

_________________________________________________________________________________________________________________

8. Do you anticipate any substantial inheritances? F Yes F No

REPRESENTATIONS AND WARRANTIES:The information contained in this statement is provided to induce you to extend or to continue the extension of credit to the undersigned or to others upon the guarantee of the undersigned. The undersigned acknowledge and understand that you are relying on the information provided herein in deciding to grant or continue credit or to accept a guarantee thereof. Each of the undersigned represents, warrants and certifies that the information provided herein is true, correct and complete. Each of the undersigned agrees to notify you immediately and in writing of any change in name, address, or employment and of any material adverse change (1) in any of the information contained in this statement or (2) in the financial condition of any of the undersigned or (3) in the ability of any of the undersigned to perform its (or their) obligations to you. In the absence of such notice or a new and full written statement, this should be considered as a continuing statement and substantially correct. If the undersigned fail to notify you as required above, or if any of the information herein should prove to be inaccurate or incomplete in any material respect, you may declare the indebtedness of the undersigned or the indebtedness guaranteed by the undersigned, as the case may be, immediately due and payable. You are authorized to make all inquiries you deem necessary to verify the accuracy of the information contained herein and to determine the credit-worthiness of the undersigned. The undersigned authorize any person or consumer reporting agency to give you any information it may have on the undersigned. Each of the undersigned authorizes you to answer questions about your credit experience with the undersigned. As long as any obligation or guarantee of the undersigned to you is outstanding, the undersigned shall supply annually an updated financial statement. This personal financial statement and any other financial or other information that the undersigned give you shall be your property.

___________________________________________________________ ____________________Your Signature Date

___________________________________________________________ ____________________Co-Applicant’s Signature (if you are requesting the financial accommodation jointly) Date


Page 1 of 2

GENERAL INSTRUCTIONSWhat is this form?

To help the government fight financial crime, Federal regulation requires certain financial institutions to obtain, verify, and record information about the beneficial owners of legal entity customers. Legal entities can be abused to disguise involvement in terrorist financing, money laundering, tax evasion, corruption, fraud, and other financial crimes. Requiring the disclosure of key individuals who own or control a legal entity (i.e., the beneficial owners) helps law enforcement investigate and prosecute these crimes.

Who has to complete this form?

This form must be completed by the person opening a new account on behalf of a legal entity with any of the following U.S. financial institutions: (i) a bank or credit union; (ii) a broker or dealer in securities; (iii) a mutual fund; (iv) a futures commission merchant; or (v) an introducing broker in commodities.

For the purposes of this form, a legal entity includes a corporation, limited liability company, or other entity that is created by a filing of a public document with a Secretary of State or similar office, a general partnership, and any similar business entity formed in the United States or a foreign country. Legal entity does not include sole proprietorships, unincorporated associations, or natural persons opening accounts on their own behalf.

What information do I have to provide?

This form requires you to provide the name, address, date of birth and Social Security number (or passport number or other similar information, in the case of foreign persons) for the following individuals (i.e., the beneficial owners):

(i) Each individual, if any, who owns, directly or indirectly, 25 percent or more of the equity interests of the legal entity customer (e.g., each natural person that owns 25 percent or more of the shares of a corporation); and

(ii) individual with significant responsibility for managing the legal entity customer (e.g., a Chief Executive Officer, Chief Financial Officer, Chief Operating Officer, Managing Member, General Partner, President, Vice President, or Treasurer).

The number of individuals that satisfy this definition of “beneficial owner” may vary. Under section (i), depending on the factual circumstances, up to four individuals (but as few as zero) may need to be identified. Regardless of the number of individuals identified under section (i), you must provide the identifying information of one individual under section (ii). It is possible that in some circumstances the same individual might be identified under both sections (e.g., the President of Acme, Inc. who also holds a 30 percent equity interest). Thus, a completed form will contain the identifying information of at least one individual (under section (ii)), and up to five individuals (i.e., one individual under section (ii) and four 25 percent equity holders under section (i)). The financial institution may also ask to see a copy of a driver’s license or other identifying document for each beneficial owner listed on this form.

CERTIFICATION OF BENEFICIAL OWNER(S) Persons opening an account on behalf of a legal entity must provide the following information:

A. Name and Title of Natural Person Opening Account

B. Name and Address of Legal Entity for Which the Account is Being Opened:

C. The following information for each individual, if any, who, directly or indirectly, through any contract, arrangement, understanding, relationship or otherwise, owns 25 percent or more of the equity interests of the legal entity listed above:

Name (First, MI, Last, Suffix)

Date of Birth (MM/DD/YYYY)

Address (Residential or Business Street)

For U.S. Persons: Social Security NumberFor Non-U.S. Persons: Passport Number and Country of Issuance, or other similar identification number*

U.S. Person Non-U.S. Person




(If no individual meets this definition, please write “Not Applicable.”)*In lieu of a passport number, foreign persons may also provide an alien identification card number, or number and country of issuance of any other government-issued document evidencing nationality or residence and bearing a photograph or similar safeguard.

BENEFICIAL OWNERS OF LEGAL ENTITY CUSTOMERS

D. The following information for one individual with significant responsibility for managing the legal entity listed above, such as: • An executive officer or senior manager (e.g., Chief Executive Officer, Chief Financial Officer, Chief Operating Officer, Managing Member, General Partner, President, Vice

President, Treasurer); or • Any other individual who regularly performs similar functions. (If appropriate, an individual listed under section (c) above may also be listed in this section (d)).

Name (First, MI, Last, Suffix)

Date of Birth (MM/DD/YYYY)

Address (Residential or Business Street)

For U.S. Persons: Social Security NumberFor Non-U.S. Persons: Passport Number and Country of Issuance, or other similar identification number*





I, _________________________________________________________________________ (name of natural person opening account), hereby certify, to the best of my knowledge, that the

information provided above is complete and correct.

Signature

Date (MM/DD/YYYY)

Legal Entity Identifier (Optional)

BENEFICIAL OWNERS OF LEGAL ENTITY CUSTOMERS (cont)

Documents

COMMERCIAL LOAN APPLICATION CHECKLIST · COMMERCIAL LOAN APPLICATION CHECKLIST Thank you for considering Apple Federal Credit Union for your business financing request. Please use