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Business Loan Application

Credit Union regulations require that applicants be within our member service area.

Date: 04/18/2014
Business Name:
Business Activity:
TIN#:
Street, City and Zip Code:
County:
Phone #:
Fax #:
E-Mail Address:
Visions FCU Member?:
Yes
No
Legal Structure:
Proprietorship
Partnership
Corporation
Limited Liab. Co.
Other
If "other", please specify:
State of Organization (Only if LLC or Corporation):
Counties of Operation:
Date Business Started:
Month: Day: Year:
Under Current Management Since:
Month: Day: Year:
Are there Affiliates/Related parties?:
Yes
No
Principal(s)/Authorized Officer Name & Address:
Title(s):
Ownership %:
Social Security #:
DOB(mm/dd/yyyy):
Principal(s)/Authorized Officer Name & Address:
Title(s):
Ownership %:
Social Security #:
DOB(mm/dd/yyyy):

The Loan Request(s):

Business Loan Purpose(s):
1)
2)
Assets Being Acquired:
Seller:
Cost (exclude taxes and shipping):
Down Payment (indicate if cash or trade):
Loan Amount Requested (amount you are looking to borrow):
Assets Being Acquired:
Seller:
Cost (exclude taxes and shipping):
Down Payment (indicate if cash or trade):
Loan Amount Requested (amount you are looking to borrow):
Other Security/Collateral:
Primary Source of Repayment:
Other Sources of Repayment:
Additional Information:

I / We undersigned, authorize Visions 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(s):
Date: 04/18/2014
Signature:
Title(s):
Date: 04/18/2014

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 denied. Your request should be directed to VISIONS FEDERAL CREDIT UNION, 1 Credit Union Plaza, 24 McKinley Avenue, Endicott, NY 13760; attn: Commercial Loan Officer phone number (607) 786-2000. This statement will be sent to you within 30 days of receipt.

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 this law is the National Credit Union Administration: 9 Washington Square; Washington Avenue Ext., Albany, NY 12205.