ECIDA - RDC Business Loan / Line of Credit Application
A. Business Information:
Business Legal Name: _______________________________________________________________
Business Address: ____________________________________
____________________________________
Tax ID Number: ______________________________
Business Contact Name: __________________________ Business Contact Phone Number: _________________
Business Contact Email Address:
Legal Structure: □ C-Corp. □ S-Corp □ LLC
Website:
□ General Partnership □ Limited Partnership □ Sole Proprietorship
Date Business was established: _____________ Employment: Current FT: ___; PT: ___ At Year 3: FT: ___; PT: ___
Description of Business:
Is the business (check all that apply): MBE: □ WBE: □ Veteran Owned: □ N/A □
B: Loan Highlights:
RDC Term Loan Amount:
RDC Line of Credit Amount: _________________
+Bank Loan Amount:
+Bank Loan Amount: __________________
+Borrower Equity:
+Borrower Equity: __________________
= Total Project Cost:
= Total Project Cost: ___________________
If applying for a Line of Credit is your business (check all that apply):
Commercial Contractor: ____ Commercial Building Trades: ____ Agribusiness (non-cannibas): ____
Day Care Center (non-home based): _____ Other: ______________________
Description of how funds are to be used:
Please list the assets you wish to use as collateral: □ Real Estate □ Equipment □ A/R Inventory □ Other
Address (if real estate): ________________________________________________________________________
Property Description: _________________________________________________________
Business Schedule of Long-Term Debts
Lender Name
Original Amount
Current Loan Balance
Monthly Payment
Total
Page: 1
1. Name: ______________________________________________________ U.S. Citizen: Yes: ___ No: ___
Address: ____________________________________________________
____________________________________________________
Date of Birth: _________________
Email: ________________________________________ Phone/Cell Number: ___________________
% of Ownership: ____________ Title: ________________________ Length as Owner: _______________
2. Name: ______________________________________________________ U.S. Citizen: Yes: ___ No: ___
Address: ____________________________________________________
____________________________________________________
Date of Birth: _________________
Email: ________________________________________ Phone/Cell Number: ___________________
% of Ownership: ____________ Title: ________________________ Length as Owner: _______________
Bank/Lending Institution:
Bank Contact Name:
Phone Number:
Title:
Email Address:
Firm Name:
Phone Number:
Contact Name:
Email Address:
Agency Name: _____________________________________ Contact Name: _____________________________
Phone Number: _____________________________________ Email Address: _____________________________
G: Miscellaneous:
□ Yes
□ No
Is the Company or its principals presently the subject of any litigation, or is any litigation threatened,
which would have a material adverse effect on the Company’s financial condition?
□ Yes
□ No
Has the Company or its principals ever settled a debt with a lending institution for less than the full
amount outstanding?
□ Yes
□ No
Has the company, its affiliates or its principals ever filed bankruptcy, a creditor’s rights or receivership
proceeding, or sought protection from creditors?
□ Yes
□ No
Has the Company or its principals ever been convicted of any felony or misdemeanor, other than a minor
traffic violation, or are any charges pending?
□ Yes
□ No
Has the Company, its affiliates or its principals, been cited for a violation of federal, State or local laws or
regulations with respect to labor practices, hazardous wastes, environmental pollution or operating
practices?
□ Yes
□ No
Are there any outstanding judgments or lien pending against the Company, its affiliates or its principals
other than liens in the normal course of business? Amount: $
□ Yes
□ No
Has the company or principal(s) ever been issued an injunction, been imposed civil penalties or fines?
been accused of false or misleading statements, or been the subject of a proceeding or had any allegations
made against them, by any federal, state, local agency or authority including but not limited to the SEC,
FCC, FDA, or OSHA? If yes, please attach a written explanation to this application.
Page: 2
C: Personal/Guarantor(s) Information:
D: Primary Lender Information
E: Attorney Information
F: Insurance Agent
□
Business Plan (Company history, ownership, key management/experience, description of products/services, description
of facility, primary suppliers, target market, competition etc.)
□
Most recent three (3) years of business tax returns.
□
Most recent interim financial statements (income statement and balance sheet).
□
Three (3) years projected financial statements (income statement and balance sheet)
□
Accounts Receivable Aging and/or Inventory Listing (Line of Credit only)
□
Most recent three (3) years owners/guarantors tax returns for individuals owning 20% or greater of business.
□
Completed Personal Financial Statement on each guarantor owning 20% or greater of business.
□
Declination letter from bank or lending institution.
□
Federal Regulations acknowledgement form
□
Other financial information may be required as requested.
Acknowledgment: The Applicant/I acknowledge that the Buffalo and Erie County Regional Development Corporation,
and the Buffalo and Erie County Industrial Land Development Corporation are subject to New York State’s Freedom of
Information Law (FOIL) and the New York Open Meetings Law as codified pursuant to the New York Public Officers Law.
Applicant/I understand that all information and records related to this application are potentially subject to disclosure under
FOIL subject to limited statutory exclusions.
Authorization: I hereby authorize the RDC/ILDC and or its affiliates to request , verify and review all data you require
about the company and its principals/guarantors, including but not limited to, credit reports and/or background information
obtained from your bank (as identified on this application) third-party service providers/agencies, now and for all future
reviews of this application and/or for collection of loan. I authorize you to give credit and/or background information ob-
tained about me and the company to others, for the purpose of evaluating my application. Applicant acknowledges that all
the information in this application and other materials furnished by the company for your review is true and accurate and
that there are currently no material adverse changes which may affect said information.
Borrowers Acknowledgment and Signatures: I have read the foregoing application and the attachments and know the
contents thereof, and hereby represent, including but not limited to, and otherwise agree that I am aware of and will
comply with federal statutory and regulatory requirements that apply to activities carried out with anticipated loan proceeds.
Upfront Cost Requirements: Applicants understand that the personal credit report and business credit report costs remit-
ted with this application are non-refundable.
Authorized Signer Title Date
Personal Guarantor #1 Title Date
Personal Guarantor #2 Title Date
Page: 3
ECIDA 95 Perry St., Suite 403, Buffalo, NY 14203 (Ph.)716.856.6525 (Fax)716.856.6754
H: Required Financial and Business Information:
I: Acknowledgment, Authorization and Signatures:
