Business Credit Application Form
Business Credit Application Form
Please complete this form to apply for a business line of credit or financing with [Your Company Name].
Business Information
Legal Business Name
DBA (if applicable)
Business Address
Business Phone Number
Business Email
Business Website
Type of Business Entity
-
Sole Proprietorship
-
Partnership
-
LLC
-
Corporation
Date Established
Federal Tax ID (EIN)
Owner/Principal Information
Name
Job Title
Ownership Percentage
Phone Number
Home Address
Business Financial Information
Annual Revenue Amount
Net Profit Amount (Last Year)
Number of Employees
Current Business Debt (if any)
Current Banking Institution
Account Number
Credit Request Information
Credit Amount Requested
Purpose of Credit
-
Working Capital
-
Equipment Purchase
-
Inventory Financing
-
Expansion
Preferred Payment Terms
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12 Months
-
24 Months
-
36 Months
-
Additional Information
Have you or your business ever filed for bankruptcy?
Any Additional Notes or Special Requests
Specify any preferences or questions.
By signing below, you authorize [Your Company Name] to verify your business information and to conduct a credit check as part of this application process.
Signature of Authorized Signer
Name:
Date:
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