R.I.S.E. Loan Application - Hendricks County Economic Development Partnership

Hendricks County Economic Development Partnership R.I.S.E Loan Application

BUSINESS INFORMATION
Business Name :*
Address*
Street Address Address Line 2 City State ZIP Code
Telephone*
Tax I.D :*
NAICS :*
DUNS # :*
Individual Name(s) :*
Address*
Street Address Address Line 2 City State ZIP Code
Telephone :*
Social Security # :*
Date of Birth :*
Date Format: DD slash MM slash YYYY
Business type:*
- Sole-Proprietorship
- Partnership
- For-profit Corporation
- Nonprofit Corporation
- Professional Corporation
- Benefit Corporation
- LLP
- LLC
- Series LLC
Indiana Business ID (If applicable):
Ownership Distribution: (List stockholders, partners, owner names)*
Name Title # of Years % SS#
Nature of Business :*
Year Established :*
Where was business founded?*
Years at Present Location :*
Number of Employees :*
*
- Own
- Lease
Accountant :*
Telephone :*
Insurance Agent :*
Telephone :*
Attorney :*
Telephone :*

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FINANCIAL INFORMATION
Bank of Account :*
Account Number :*
Credit Relationships :*
Please provide details of your business credit relationships below:
Credit Relationships*
Name of Creditor : Purpose of Loan : Original Loan Amount : Amount Presently Owing : Repayment Terms : Maturity Date
CURRENT AND PROJECTED EMPLOYMENT
Note: To the maximum extent possible, the applicant will utilize the employment or labor use of low-income persons.
- Professional/Managerial/Technical
- Skilled
- Unskilled/Semi-Skilled
Existing Jobs*
Type (from list above) FT/PT Employees
Future Projections - Year One*
Type (from list above) FT/PT Employees
Future Projections - Year Two*
Type (from list above) FT/PT Employees
LOAN REQUEST
Amount of Loan Requested :*
Max. amount = $15,000
Requested Term of Loan (in months)*
(not to exceed 48 months)
Specific Loan Purpose (Check all that Apply)*
- Finance Hiring Consultant for Tech/Innovative Practices
- Finance Marketing Strategy
- Finance Purchase of Equipment
- Finance Implementation of Technology
- Finance other Consulting, Auditing, Or Implementation to Help Recover from Impacts of Covid-19
- Other (please explain, in detail, the item/service and its purpose – attach as separate sheet)
Other purpose for loan:*

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Guarantors
For incorporated borrowers, guarantees of owner(s) is usually required, unless secured by Bank deposits or marketable collateral. If personal assets are in joint names and/or are part of a partnership, the Bank may require all parties to pledge collateral
Name*
Social Security #*
Address*
Name*
Social Security #*
Address*
Name*
Social Security #*
Address*
BUSINESS BACKGROUND INFORMATION
Please provide a brief history of your business, future plans and projections, and describe your products and /or services and competition.*
PERSONAL BUSINESS EXPERIENCE
Please describe your previous business experiences and include a list of references. Include business background, management experience, and training, or include a resume.*

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REQUIRED ATTACHMENTS
Please be sure all of the following documentation has been included.
- Business Plan
- Innovative Small Business Loan Fund Application
- Business Financial Statements (Profit and Loss, Balance Sheet) for the past three fiscal years
- Business Federal Tax Returns for past three fiscal years
- Interim Financial Statements (if available)
- Most Recent Federal Tax Returns for each principal owner listed in the first section of the Business Loan Application
- Signed Personal Financial Statements for any person owning at least 20% of the business
- Organizational Papers (Articles, dba papers, etc.)
- Information which may further secure the loan
- Documentation as to the source of equity
- Documentation as to how the project will benefit the community and impacts the mission of the Innovative Small Business Fund
- Provide Secretary of the State Legal Entity Report
- Commitment letter from other parties participating in the project
- Copy of commitment letter from bank regarding line of credit for working capital
- Copy of secured permits, if applicable
Attach all files here.*
Drop files here or

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CERTIFICATION
I declare that any statement in this application and in its required attachments or information provided herein, is true and complete in substance and in fact. Further, I hereby authorize any financial institutions in which the loan applicant and any guarantor thereof has any loans to provide any and all financial information of the loan applicant and/or any guarantor thereof requested by the Hendricks County Economic Development Partnership and this authorization constitutes a waiver of any and all laws and regulations concerning any privacy and applicant and guarantor also indemnifies and holds harmless said financial institutions for the release of any such information pursuant to this section of the loan application. This Information will be secured for the purpose of determining the applicant's eligibility, Innovative Small Business Loan Fund standards conformance and financial soundness of the applicant.
Business Name (print):*
Applicant Full Name:*
Date*
Date Format: MM slash DD slash YYYY
Guarantor(s) Full Name:*
Date*
Date Format: MM slash DD slash YYYY
Guarantor(s) Full Name:
Date
Date Format: MM slash DD slash YYYY
FEE CHARGE: An application fee of $25 will be due at the time the loan application is submitted. Payment can be remitted by Check, Electronic Funds Transfer through Paypal, or Cash. Please advise HCEDP of your preferred payment method and an appropriate invoice will be issued.
Payment option:*
- Invoice me for Check
- Invoice me for PayPal
- Invoice me for Cash
This is an Equal Opportunity Program. Discrimination is prohibited by Federal Law. POLICY STATEMENT ON DISCRIMINATION IN LENDING The Department of Housing and Urban Development ("HUD"), the Department of Justice ("DOJ"), the Office of the Comptroller of the Currency ("OCC"), the Office of Thrift Supervision ("OTS"), the Board of Governors of the Federal Reserve System (the "Board"), the Federal Deposit Insurance Corporation ("FDIC"), the Federal Housing Finance Board ("FHFB"), the Federal Trade Commission ("FTC"), the National Credit Union Administration ("NCUA"), and the Office of Federal Housing Enterprise Oversight ("OFHEO") (collectively, "the Agencies") are concerned that some prospective home buyers and other borrowers may be experiencing discriminatory treatment in their efforts to obtain loans. The 1992 Federal Reserve Bank of Boston study on lending discrimination, Congressional hearings, and agency investigations have indicated that race is a factor in some lending decisions. Discrimination in lending on the basis of race or other prohibited factors is destructive, morally repugnant, and against the law. It prevents those who are discriminated against from enjoying the benefits of access to credit. The Agencies will not tolerate lending discrimination in any form. Further, fair lending is not inconsistent with safe and sound operations. Lenders must continue to ensure that their lending practices are consistent with safe and sound operating policies. This policy statement applies to all lenders, including mortgage brokers, issuers of credit cards, and any other person who extends credit of any type. The policy statement is being issued for several reasons, including:
• To provide guidance about what the agencies consider in determining if lending discrimination exists; and
• To provide a foundation for future interpretations and rulemakings by the Agencies.
A number of federal statutes seek to promote fair lending. For example, the Home Mortgage Disclosure Act ("HMDA"), 12 U.S.C. 2801 et seq., seeks to prevent lending discrimination and redlining by requiring public disclosure of certain information about mortgage loan applications. The Community Reinvestment Act ("CRA"), 12 U.S.C. 2901 et seq., seeks affirmatively to encourage institutions to help to meet the credit needs of the entire community served by each institution covered by the statute, and CRA ratings take into account lending discrimination by those institutions. The Americans with Disabilities Act, 42 U.S.C. 1210 et seq., prohibits discrimination against persons with disabilities in the provision of goods and services, including credit services. This policy statement, however, is based upon and addresses only the Equal Credit Opportunity Act ("ECOA"), 15 U.S.C. 1691 et seq., and the Fair Housing Act ("FH Act"), 42 U.S.C. 3601 et seq., the two statutes that specifically prohibit discrimination in lending. This policy statement has been approved and adopted by the signatory Agencies listed above as a statement of the Agencies' general position on the ECOA and the FH Act for purposes of administrative enforcement of those statutes. It is intended to be consistent with those statutes and their implementing regulations and to provide guidance to lenders seeking to comply with them. It does not create or confer any substantive or procedural rights on third parties which could be enforceable in any administrative or civil proceeding. This policy statement will discuss what constitutes lending discrimination under these statutes and answer questions about how the Agencies will respond to lending discrimination and what steps lenders might take to prevent discriminatory lending practices.

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Hendricks County Economic Development Partnership R.I.S.E Loan Application

Step 1 of 6

BUSINESS INFORMATION

FINANCIAL INFORMATION

CURRENT AND PROJECTED EMPLOYMENT

LOAN REQUEST

Guarantors

BUSINESS BACKGROUND INFORMATION

PERSONAL BUSINESS EXPERIENCE

IMPACT OF COVID-19

MISCELLANEOUS INFORMATION

DEMOGRAPHIC INFORMATION

REQUIRED ATTACHMENTS

CERTIFICATION

FEE CHARGE: An application fee of $25 will be due at the time the loan application is submitted. Payment can be remitted by Check, Electronic Funds Transfer through Paypal, or Cash. Please advise HCEDP of your preferred payment method and an appropriate invoice will be issued.

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Name	Title	# of Years	%	SS#

Name of Creditor :	Purpose of Loan :	Original Loan Amount :	Amount Presently Owing :	Repayment Terms :	Maturity Date

Type (from list above)	FT/PT	Employees

Type (from list above)	FT/PT	Employees