Member Business Purpose
Loan Application
StreamLiner
SM
For Vehicle & Equipment Loans
INFORMATION ABOUT THE BUSINESS
Legal Name
Trade Name (if different)
Tax ID #
Street Address
Mailing Address (if different)
Name / Title of Primary Contact
E-mail Address
Business Phone #
Legal Structure of Business:
Business Fax #
Date Business Established
Proprietorship
C-Corporation
Limited Liability Company
S-Corporation
General Partnership
Non-Profit Organization
Other (explain)
Description of Business Products/Services
INFORMATION ABOUT PRINCIPALS
1.
1. Name / Title
Social Security #
Home Address
2.
Date of Birth
% Ownership
2. Name / Title
Social Security #
Home Address
Date of Birth
% Ownership
Mobile & Home Phone #’s
# Yrs in this line of
work?
# Yrs. as
Manager/Owner?
Mobile & Home Phone #’s
# Yrs. in this line of
work?
# Yrs. as
Manager/Owner
Each owner of business must provide a personal guaranty. If business has more than two owners, provide additional owner information on separate page.
LOAN REQUEST
Loan Type:
Vehicle
Amount Requested
Machinery / Equipment
Please provide information on the item including year, make, model, serial # or VIN, as well as mileage or hours on the engine, as applicable.
DEBT SCHEDULE (Detail all existing business loans and leases currently owed by the business OR, if a d/b/a, by the individual borrower)
Creditor Name
Original
Amount
Current
Balance
Monthly
Payment
Maturity
Date
Collateral Securing Loan
OTHER INFORMATION
Please feel free to provide any additional information that may be helpful when considering this application.
CERTIFICATION & AUTHORIZATION
By signing below, I/We hereby certify that I/We am/are authorized to submit this loan application and
accompanying materials to Evergreen Credit Union and to request the credit facilities described herein.
Furthermore, I/We certify that all information contained in this application package is accurate and fairly
represents the status of the business, financially or otherwise. Additionally, I/We authorize Evergreen Credit
Union to obtain references and credit reports, both business and personal.
Applicant’s Signature
Printed Name / Title
Date
Co-Applicant’s Signature
Printed Name / Title
Date
 ⁯ By checking this box, co-applicants acknowledge their intention to apply for joint credit.
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 contracts), 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 administering compliance regarding this creditor is the Federal Trade Commission,
Equal Credit Opportunity, Washington, DC 20580