Loan Application - Creative Lending Solutions

Date:

Loan Amount Requested:

USD

Intended Use of Funds:

Owner Information (1)

Full Legal Name:

Years as Owner:

Home Address (no PO boxes):

City/State

ZIP Code

Doing Business As (DBA):

Rent or Own Business Location:

Landlord Name & Phone:

Home Phone:

Cell Phone:

% Ownership:

Social Security No:

Date of Birth:

E-mail Address:

Driver’s License #:

State of Issue:

Years at Current Address:

Annual Income:

USD

Other Income $/per:

Source(s) of other income:

Owner Information (2)

Full Legal Name:

Years as Owner:

Home Address (no PO boxes):

City/State

ZIP Code

Doing Business As (DBA):

Rent or Own Business Location:

Landlord Name & Phone:

Home Phone:

Cell Phone:

% Ownership:

Social Security No:

Date of Birth:

E-mail Address:

Driver’s License #:

State of Issue:

Years at Current Address:

Annual Income:

USD

Other Income $/per:

Source(s) of other income:

By signing & faxing or emailing us your application, you certify that (i) you are authorized to apply on behalf of the company
whose full legal name appears above under the Company Information portion of the Loan Application for a business loan from
us and (ii) all information you provide within the Loan Application and other supporting documents is true and complete and that
you will notify us of material changes to such information. You understand & agree that we and our agents and assignees are
authorized to contact 3rd parties to make inquires in evaluating your Loan Application (including requesting business & personal
credit bureau reports from credit reporting agencies and other sources) or for any update, renewal, extension of credit bureau name
and address. You understand and agree that we may provide credit & other information from the Loan Application and on the signing
individual(s) & the company with 3rd parties who may use the information any lawful purpose, including for the purpose of offering
credit and/or other products & services to the signing individual(s) and/or the company.

Upload Your Last 4 Month Bank Statement

No file chosen

Loan Information

Signature (1):

Signature(2)