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Business Information

Company Name

Business Phone

Business Fax

Business Address

Address

City

State

Zip

Amount Requested

Federal I.D. No

Date of incorporation

Type of Incorporation/Ownership

Type of Business

Owner 1
* Required Fields

Full Legal Name*

First Name

Middle Initial

Last Name

Title*

Ownership %*

SSN Number*

Phone (Home)

Phone (Cell)

Date of Birth*

Email Address*

Home Address*

Address

City

State

Zip

Owner 2
(If Applicable)

Full Legal Name

First Name

Middle Initial

Last Name

Title

Ownership %

SSN Number

Phone (Home)

Phone (Cell)

Date of Birth

Email Address

Home Address

Address

City

State

Zip

Financial Needs
* Required Fields

Describe what your financial needs are. Please be specific.*

Terms of Financing

Purchase Price

Has Any Owner/Officer filed Bankruptcy in the last 5 Years?*

Yes

Do you have collateral that you would like to pledge?

Yes

If so, please describe items with estimated value:

Financial Documents
(If Applicable)

Uploading your financial documents will speed up your loan process. Please upload the following:

Most recent business bank statements - 3 months
Most recent business and personal tax returns - 2 years
Most recent 1099 (if applicable)
Current business profit & loss statement and financial statement
Credit report (if available)

File 1:
File 2:
File 3:
File 4:
File 5:

By signing above I/We certify that the information above is true and understand that making false statements might be considered fraud. Applicant named above herby authorizes Superior Business Lending and it's affiliates, assigns, agents, banks or financial institution to obtain and view a credit report submitted by applicant.

Submitting this application is equivalent to a signature.

(800) 994-0684

1532 West Wolfram Street

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Financing you can count on

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