Loan Application - Benchmark Loan Partners

Loan Information

Requested Loan Amount*

Years in Business*

Purpose of Loan*

Is the debt to be refinanced in your personal name or the name of the business?*

Do you have another intended use of proceeds?*

Additional Use of Proceeds*

Referral Source*

Business Information

Legal Business Name*

Tax Identification or SS Number (exclude dashes)*

Business Address*

Business Address Line 1 Business Address Line 2 City State ZIP Code

How long have you owned the business?*

What % of this business do you own?*

Please enter the name, email address, and ownership percentage of all additional owners of the business.*

Business Type*

Industry*

Other*

Please upload your most recent BUSINESS tax return*

Max. file size: 32 MB.

Do you own any other businesses?*

Please enter the name(s) of the other business(es) you own.*

Business Information for the Business to be ACQUIRED

Legal Business Name of Seller*

Tax Identification Number of Seller (exclude dashes)

Address*

Business Street Address Business Street Address 2 City State ZIP Code

Please upload the most recent business tax return for the business to be acquired

Max. file size: 32 MB.

Additional Supporting Documentation (e.g., Profit and Loss Statement)

Max. file size: 32 MB.

Outstanding Business Debt Balance*

Total Business Debt Monthly Payment*

Personal Information

First Name*

Middle Name*

Last Name*

Date of Birth*

Phone Number*

Personal Credit Score*

Email*

Social Security Number (exclude dashes)*

Personal Address*

Street Address Address Line 2 City State ZIP Code

Please upload your most recent PERSONAL tax return*

Max. file size: 32 MB.

Supplemental Questions

Outside Income*

Personal Liquidity*

Terms and Conditions

You understand that by selecting "I AGREE" from the dropdown immediately following this notice, you are providing ‘written instructions’ to Benchmark Loan Partners, LLC (Benchmark) under the Fair Credit Reporting Act authorizing Benchmark to obtain information from your personal credit profile or other information from one or more consumer credit bureau(s). You are authorizing Benchmark to obtain such information solely to conduct a pre-qualification for credit purposes. You are also authorizing Benchmark to make inquiries as necessary to verify the accuracy of the documents you provide as part of the commercial loan underwriting process and, if necessary, you will provide additional information to determine the creditworthiness of the individual owners and/or guarantors. You acknowledge that you are personally liable for the business applying for the commercial loan. You hereby release and agree to save and hold Benchmark, including its directors, officers, employees, and agents harmless from any liability which might arise.

Do you agree?*

Maintenance of Confidential Information

Benchmark agrees that all information concerning borrower’s loan application shall be maintained in the strictest confidence and shall not be disclosed to any third parties except as may be provided to the Lender contemplating this loan application and applicable state and federal law. The protection of confidential customer information is required at all times and Benchmark shall at all times comply with relevant state and federal regulations regarding disclosure of confidential information, including but not limited to the Gramm-Leach-Bliley Act (15 U.S.C. 6801-6809) the Fair Credit Reporting Act (15 U.S.C. 1681 et seq.), the Privacy Act of 1974 (5 U.S.C. 552(a)), and the Right to Financial Privacy Act of 1978 (12 U.S.C. 3401, et seq.). This provision shall survive whether the borrower’s loan closes or not. In the event that Benchmark or any of its representatives or agents is requested or required (by oral question or request for information or documents in legal proceedings, including interrogatories and subpoena) to disclose any Confidential Information, it is agreed that Benchmark shall provide Borrower and/or Applicant with prior written notice of any such request or requirement so that the Applicant and/or Borrower may contest such an order, seek an appropriate protective order and/or waive compliance with the provisions of this Agreement. If Borrower and/or Applicant does not take action relative to any notice provided by Benchmark within 5 business days, Benchmark shall be permitted to respond to any lawfully issued subpoena or request made in a legal proceeding in accordance with applicable laws in effect at that time.