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Business Loan Application
Submitter Information (Required)
First Name
(required)
Last Name
(required)
Resolve the errors marked in red before submitting again.
1. Loan Request

Business must be located in Saginaw, Bay, or Midland County. Maximum Aggregate Credit Exposure $250,000. (Customers with existing loans at 1st State Bank please contact your Business Lender)

Loan Type (required)
Line of Credit Dollar Value
Equipment Dollar Value
Real Estate Dollar Value
Other Dollar Value
Description/ Purpose of Loan Requests (required)
Available Collateral
Accounts Receivable Dollar Value
Inventory Dollar Value
Equipment Dollar Value
Vehicle Dollar Value
Real Estate Dollar Value
Other Collateral Dollar Value
2. Business Information
Business Classification (required)
Business Name (required)
Tax / Employee Identification Number (required)
Company Address (required)
Business Phone (required)
Business Contact Name (required)
Business Contact Email (required)
Today's Date (required)
Date Business Established (required)
Present Management/ Ownership Since (required)
Recent Year-End Gross Revenue (required)
Recent Year-End Net Profit (Loss) (required)
3. Owners/Guarantors

List any individual who has 20% or more ownership or would be a guarantor of the loan.

Owner/ Guarantor #1
Owner/ Guarantor #1
Owner/Guarantor #1 NameTitleOwnership PercentageSSN#/TIN#Date of BirthPhone

 
Owner/ Guarantor #1 Address
Owner/ Guarantor #2
Owner/ Guarantor #2
Owner/ Guarantor #2 NameTitleOwnership PercentageSSN#/TIN#Date of BirthPhone

 
Owner/ Guarantor #2 Address
Owner/ Guarantor #3
Owner/ Guarantor #3
Owner/ Guarantor #3 NameTitleOwnership PercentageSSN#/TIN#Date of BirthPhone

 
Owner/ Guarantor #3 Address
Owner/ Guarantor #4
Owner/ Guarantor #4
Owner/ Guarantor #4 NameTitleOwnership PercentageSSN#/TIN#Date of BirthPhone

 
Owner/ Guarantor #4 Address
4. Additional Information
Has the business incurred any loss in the last three years?
Is the business, owners, or guarantors party to any claim, judgement, or lawsuit?
Has the business, owners, or guarantors been involved in any bankruptcy proceedings?
Are more than 20% of revenues from, or expenses to, a related entity?
Is the business or any of its assets for sale or under agreement for sale?
5. Certifications

A. If multiple applicants/ guarantors are joining in on this application, the undersigned intend to apply jointly as Borrowers and/or Guarantors of the loans for the company listed on the application, if applicable. The assets and income of each Borrower and Guarantor will be relied upon as a basis for the loan request. 

B.  Each undersigned (1) certifies that all information furnished and to be furnished in connection with this application is and will be true and complete, without omission of information, and fairly represents the financial condition of the Borrowers and/or Guarantors; and (2) grants connection with the application, including but not limited to business and personal credit reports.

C. 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 concerning this creditor is FDIC Consumer Response Center, 1100 Walnut Street, Box #11, Kansas City, MO 64106.

6. Signatures
Company Representative Signature
Company Legal Name (required)
Signature (required)
Title (required)
Owner/ Guarantor #1 Signature
Owner/ Guarantor #1 Signature (required)
Print Name (required)
Owner/ Guarantor #2 Signature
Owner/ Guarantor #2 Signature
Print Name
Owner/ Guarantor #3 Signature
Owner/ Guarantor #3 Signature
Print Name
Owner/ Guarantor #4 Signature
Owner/ Guarantor #4 Signature
Print Name
Upon receipt of your application, you will be contacted by a 1st State Bank Business Lender within one business day.