Commercial Loan Application

Questions? Please contact your loan officer www.faheybank.com 1-740-382-8231

PRELIMINARY CLOSING/PACKAGING CHECKLIST This checklist has been provided to assist you in gathering the necessary information for the credit evaluation of your loan request. Please note that all items must contain an original signature and date. Complete information will be necessary to process your application. If you have any questions about the forms or require assistance in completing them, please contact your Loan Officer.

Financial Forms Packet (required from all applicants): 1. Loan Application Form 2. Business Debt Schedule, include creditor name, original date and amount, outstanding balance, monthly payment, next scheduled due date, interest rate and security. 3. Personal Financial Statement (Current within 90 days). Complete this form for: (1) each proprietor, or (2) each limited partner who owns 20% or more interest & each general partner, or (3) each stockholder owning 20% or more voting stock & each corporate officer and director, or (4) any other proposed person(s) or entity(s) providing a guaranty or co-borrower on the loan 4. Signed Authorization to Release Information Signed by all principals having 20% or more ownership interest in borrowing entity. 5. IRS Form 4506– “Request for Copy or Transcript of Tax Returns” – executed form required for operating business and all guarantor(s) or co-borrower(s). (Form included at the end of this application packet.).

Business & Personal Financial Exhibits (required from all applicants): 1. Business Financial Statements for three (3) prior years and interim YTD, current within 30 days, including Balance Sheets and Profit & Loss Statements, for existing business & any affiliates. (An affiliate is primarily defined as any entity that is controlled by the applicant, its’ stockholders, managers or directors or has control of the applicant business either through common ownership, management, previous relationships with or ties to another concern, and contractual relationships.) 2. Federal Tax Returns for three (3) prior years including all statements and schedules for existing business & any affiliate businesses. If current year Tax Return is on Extension, provide copy of signed extension. 3. Interim Profit & Loss, and Balance Sheet- Within 30 days old for business being: 1) acquired, 2) existing/expanded, and 3) affiliates. Also please include a comparable interim statement from the prior year. 4. Detailed Aging Report of Accounts Receivable and Accounts Payable. I t i s i m p o r t a n t t h a t t h e a c c o u n t a g i n g r e p o r t s a c c u r a t e l y m a t c h t h e b u s i n e s s e s c u r r e n t b a l a n c e s h e e t . Include for affiliate business as well.) 5. Personal Federal Tax Returns for three (3) prior years including all statements and schedules - for: (1) each proprietor, or (2) each limited partner who owns 20% or more interest & each general partner, or (3) each stockholder owning 20% or more voting stock & each corporate officer and director, or (4) other person(s) or entity(s) providing a guaranty on the loan. If current year Tax Return is on Extension, provide copy of signed extension. 6. Litigation Schedule. Include all cases other than minor vehicle violation currently in process and the prior 5 years litigation for proposed business entity(s), affiliates, guarantors, and co-borrowers. Include filing date, county and state of filing, identifying case number, disposition and disposition date. Also include a summary allegation, the maximum potential liability and if insured, name of insurance carrier and representative. 7. Written Explanation of any derogatory credit items. – If you know of any derogatory items that may appear on your personal credit report, please include a written explanation along with any supporting documentation.

PRELIMINARY CLOSING/PACKAGING CHECKLIST If your loan request involves commercial

real estate you will also need to provide:

1. Purchase Contract/Buy-Sell Agreement 2. Environmental Questionnaire (Form included) – consult with your Business Development Officer. 3. If your project involves new construction – Provide copy of the construction contract (a draft is acceptable) and a copy of the plans & specifications for the proposed project. If your project is in the early stages of development, please provide a preliminary cost analysis. 4. If your project involves refinancing – Provide a copy of the notes, lender contact information and deeds on the real estate to be refinanced.

If your loan request involves a business

acquisition you will also need to provide:

1. A copy of the proposed Purchase & Sale Agreement or Letter of Intent – complete with allocation of monies, signatures, exhibits, and addendums 2. Federal Tax Returns on Seller’s Business for three (3) prior years including all statements and schedules for existing business & any affiliates. 3. Business Financial Statements on Seller’s Business – complete Balance sheets and Profit & Loss statement of business to be acquired for the most recent last three fiscal years. 4. Interim Profit & Loss, and Balance Sheet- complete Balance sheets and Profit & Loss statement of business to be acquired, current within 45 days. 5. IRS Form 4506- T – “Request for Copy or Transcript of Tax Returns” (Form included) prepared for selling business and signed by seller.

Depending on the specifics of your loan request, you may also need to provide: 1. If your request involves a franchised business: Copy of Proposed Franchise Agreement or Letter of Approval from Franchisor 2. If your request involves a franchised business: Franchise Disclosure Document (formerly UFOC) provide a copy of the most current version of these documents. 3. If your request involves equipment financing: Purchase Orders, Invoices or Quotes – with specific details about the equipment 4. If your business is newly formed or expanding or your request is projection-based: 3 years of Business Projections Include a description of management, feasibility analysis, assumptions, site evaluation, and demographics. Note that the first year of projections must be monthly. 5. Business Plan (for new businesses in operations for 2 or fewer years or as requested) 6. Plot Plan and/or Survey 7. Lease(s) – complete copies of all existing or proposed leases.

LOAN APPLICATION APPLICANT COMPANY: Legal Business Name: dba name (if applicable): Address: City:

State:

Primary Contact:

Email:

Phone:

Zip:

Fax:

Type of Entity:

Sole Proprietorship

General Partnership

Limited Partnership

Corporation (Please specify:

Date Established: # of Employees:

Existing:

Cell:

S Corp,

C Corp,

Date Incorporated:

State of Incorporation:

After this financing:

Affiliates:

Tax I.D.:

LLC)

Website:

Name & Address of Current Bank: Name of Franchise (if applicable) PROPOSED PROPERTY (IF DIFFERENT FROM CURRENT BUSINESS ADDRESS): Address: City:

State:

Zip:

OWNERSHIP INTEREST - List below THE PROPRIETOR, owners, partners, OFFICERS and ALL stockholders IN THE BUSINESS. 100% OWNERSHIP MUST BE SHOWN Name

Title

SSN

Ownership %

AFFILIATES - List below all business concerns in which the Applicant Company or any of the individuals listed in the Ownership section above have any ownership. (If additional affiliates, please attach on separate sheet) Co. Name: Individual Name: Address: City, State, Zip: Phone:

Co. Name: Individual Name: Address: City, State, Zip: Phone:

Percent of Ownership:

Percent of Ownership:

INSURANCE INFORMATION General Liability Insurance Company:

Contact:

Phone:

Contact:

Phone:

Property Insurance Company:

Life Insurance: Does the company maintain Life Insurance on any owner or officer? If yes, provide details below. Insured:

Beneficiary:

Amount:

$

Insured:

Beneficiary:

Amount:

$

ADDITIONAL INFORMATION (For any affirmative response please attach an explanation) 1. 2. 3. 4.

Have you or any officer of your company ever been involved in bankruptcy or insolvency proceedings? Are you or your business involved in any pending lawsuits? Does your business presently, or will it as a result of this loan, engage in export trade? Are you or your business past due on any tax obligation?

Yes ■ No Yes ■ No Yes ■ No Yes ■ No

ESTIMATED PROJECT COSTS Land Purchase

$

Real Estate Purchase/New Building Construction

$

Construction Contingency/Overruns

$

Leasehold Improvements/Repairs

$

Interim Interest

$

Equipment Purchase

$

Working Capital (including Accounts Payable & Inventory)

$

Business Acquisition

$

Refinance Debt

$

Estimated Closing Costs and Third Party Reports: Survey Fee (estimated)

$

Title Insurance (estimated)

$

Appraisal Fee (estimated)

$

Legal Fees (estimated)

$

Other:

$

Conventional/Interim Loan Fee Other:

$ $

TOTAL ESTIMATED PROJECT AMOUNT

$ LESS OWN CASH/EQUITY TO BE INJECTED

$

TOTAL LOAN REQUESTED FOR PROJECT

$

For applications of credit that will involve a high priced mortgage loan or first lien on a 1-4 family residential dwelling only: You have the Right to Receive a Copy of the Appraisal. We may order an appraisal to determine the property’s value and charge you for this appraisal. We will promptly give you a copy of any appraisal, even if your loan does not close. You can pay for an additional appraisal for your own use at your own cost. By signing below, you acknowledge that you have received this disclosure. Application Deposit The Applicant is responsible for all costs incurred by the Bank and the Bank’s legal counsel whether the loan is committed and closed or not. By submitting this application, the Applicant agrees to pay all processing costs, including but not limited to, appraisals, credit reports, environmental site assessments, assets and title searches.

BUSINESS HISTORY FORM Background & History of principals and company:

Describe the products/services you offer and what they do for the customer. Please provide any company brochures or literature you have.

What geographic/demographic areas do you service? Who are your customers and where are they located, how big is the market and what is your current and desired future market share?

Does any customer represent greater than 15% of your sales? YES ■ NO If “Yes”, please provide detail about the customer including general information (sales volume, public/private, years in business, etc.) and how long you have been servicing this customer.

Who are your primary competitors? Competitor

Location

Your Competitive Advantage

How do you market your product/services? (include information about distribution channels, suppliers including concentrations, seasonal swings, etc.)

Describe your vision for the company over the next 2-3 years… 8-10 years?( I.e. growth plans, changes in customer base, future capital expenditures, current capacity vs. future, management structure. Please also describe your management succession plan should you or a key member of your management die, become disabled and/or unable to work.)

If real estate secured, describe the proposed subject collateral? Include location, date acquired price, owner renovations, site size, building size, number of units, parking, security, tenants, and lease terms, etc.

Applicant’s Signature

Date:

AUTHORIZATION TO OBTAIN AND RELEASE INFORMATION I/We hereby authorize The Fahey Banking Company to obtain any and all information they may require at any time for any purpose related to my/our credit transaction with The Fahey Banking Company including obtaining my/our personal credit history from a consumer reporting agency, and I/we authorize the release of all such information to The Fahey Banking Company. I/We further authorize The Fahey Banking Company to release such information to any entity they deem necessary for any purpose related to my/our credit transaction with them. I/We hereby certify that the enclosed information (plus any attachments or exhibits) is valid and correct to the best of my/our knowledge. I/We hereby acknowledge that all loan approvals will be in writing and subject to the terms and conditions set forth in a commitment letter signed by an officer of The Fahey Banking Company. I/We acknowledge by signing below the intent to apply jointly for credit.

Applicant/ Guarantor #1 First Name: SSN: Date of Birth: Management Experience: yrs

M.I.:

Last Name: Title:

Residential Physical Address (no PO Boxes): Street: City: State: Zip: Residence Phone: Mobile Phone: Email Address: Monthly Rent: and/or Mortgage Payment: Other Employer: years: months:

Ownership:

Monthly child support/ alimony payment Do you intend to retain this employment:

Are you a United States Citizen?………………………………………………………………….. Are you a veteran of the United States Armed Forces?......................................................... Have you ever declared bankruptcy?..................................................................................... Are you involved in any lawsuits/litigations?.……………………………………………………. Are you past due on any tax obligations?............................................................................... Have you ever defaulted on any Federally assisted loan?..................................................... Signature:

%

Yes Yes Yes Yes Yes Yes

No No No No No No

Date:

Applicant/ Guarantor #2 First Name: SSN: Date of Birth: Management Experience: yrs

M.I.:

Residential Physical Address (no PO Boxes): Street: City: State: Residence Phone: Mobile Phone: Email Address:

Last Name: Title:

Zip:

Ownership:

%

Monthly Rent: Other Employer:

and/or Mortgage Payment: years: months:

Monthly child support/ alimony payment Do you intend to retain this employment:

Are you a United States Citizen? ………………………………………………………………………………………. Are you a veteran of the United States Armed Forces?......................................................... Have you ever declared bankruptcy?..................................................................................... Are you involved in any lawsuits/litigations?.……………………………………………………………………. Are you past due on any tax obligations?............................................................................... Have you ever defaulted on any Federally assisted loan?...................................................... Signature:

Yes Yes Yes Yes Yes Yes

No No No No No No

Date:

Notice to applicants: If your application for business credit is denied, you have the right to a written statement of the specific reason for denial. To obtain a statement, please contact The Fahey Banking Company, 127 North Main Street, Marion, OH 43302-3072 within 60 days from the date you are notified of our decision. We will send you a written statement of reasons for the denial within 30 days of receiving your request for the statement. 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 a binding contract); 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 that administers compliance with this law concerning the creditor is: FDIC Consumer Response Center, 2345 Grand Boulevard, Suite 100, Kansas City, Missouri 64108 Any further inquiries or questions regarding this Authorization should be directed to: The Fahey Banking Company 127 North Main Street Marion, OH 43302 740-382-8231