Business Loan Application Business Loan Application BORROWER INFORMATION Legal Business Name * Tax ID# * D/B/A or Trade Name (if applicable) * Phone Number * Primary Business Address (Physical Business Address - no P.O. Box please) * City * Zip Code * State * Business Mailing Addresss (if different i.e. P.O. BOX) * City * State * Zip Code * Email * Description of Business / Products or Services Offered * Current Ownership Since (Date) * Date Business Established * State of Organization * LOAN REQUEST INFORMATION Term Loan Term Loan Amount Purpose of Loan Term Loan Commercial Mortgage Amount Purpose of Loan Term Loan Letter of Credit Amount Purpose of Loan Term Loan Line of Credit Amount Purpose of Loan Overdraft Protection (Required for Line of Credit Loans) BUSINESS DEPOSIT ACCOUNT Financial Institution Account Type Current Balance Financial Institution Account Type Current Balance BUSINESS DEBT Financial Institution Type of Loan Current Balance Been paid of with this loan? YesNo Financial Institution Type of Loan Current Balance Been paid of with this loan? YesNo COLLATERAL INFORMATION (Describe collateral offer to secure this loan) If cash or marketeable securities list separately below and provide statements of stock certificates. For General Business Assets, list all addresses where the assets are located. Colleteral Description of Property Address Prior Liens / Creditor * Type of Loan * AUTHORIZATION AGREEMENT The undersigned person(s) certifies that he/she has full authority to act on behalf of the business (the "Applicant") identified on the Business Loan Application (the "Application), and that all information contained herein is true and correct in all respects. Webster Bank, N.A. (the "Bank") is hereby authorized to verify any information provided in connection with the Application. The Bank may obtain credit reports for all owners / guarantors expected to be personally liable, and may also do so for updates, renewals, extensions and any collection activity or as otherwise permitted by law. Under the federal Fair Credit Reporting Act, the Bank may get or share information regarding the Applicant, guarantor(s) or Applicant's owner(s) with Bank affiliates unless the undersigned tells the Bank not to share. The undersigned may prohibit the Bank from sharing information provided or obtained by the Bank from a third party, by mailing a written request to Webster Bank, Business Banking, 609 West Johnson Avenue, Cheshire, CT 06410. The Application will be the Bank's property whether or not credit is granted. Applicant agrees that the Bank may rely on a facsimile of the Application and any other signed documents received by the Bank by facsimile transmission relating to the credit granted pursuant to the Application. Such facsimiles or any copy of such facsimiles shall be binding on Applicant and shall for all purposes be considered original documents. The undersigned understands that making false statements or material omissions intended to conceal pertinent facts may be a financial crime requiring referral to appropriate law enforcement officials. The undersigned further agree to notify the Bank immediately of any change in name, address or employment, and any material change in (a) any of the information contained in the Application, or (b) the financial condition of any of the undersigned, or (c) the ability of any of the undersigned to perform its or their obligations to the Bank. Applicant agrees that if the Bank elects to include Applicant in the Bank's SBA (U.S. Small Business Administration) loan program, the Bank may submit an SBA loan application on behalf of the Applicant using the information contained in the Application and other information obtained from the Applicant. Applicant (Business) Legal Name Officer / Member Signature Title Date Si eres humano, deja este campo en blanco. Submit Application