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LOAN PRE-QUALIFICATION
APPLICATION
To assist Passaic UEZ small businesses
Instructions:
Each person who owns 10% or more of the business MUST complete this application in order to be considered for a loan from PEZDC. All financial information can be completed using estimates. If you should be pre-qualified, PEZDC will request a complete and accurate personal financial statement and personal balance sheet from all applicants and guarantors.For more information on loan programs, or to receive assistance in completing this application, call 973-365-5520, or mail us at PEZDC, 330 Passaic Street, Passaic, NJ 07055, or Fax:973-365-5567 or email: uez@cityofpassaicnj.gov.
If "yes", what is your UEZ file #
To move forward to pages 2 and 3, you must completed all highlighted boxes and click continue.
SS#:
Collateral: (Only assets thatyou own outright can be considered as collateral)
Do you own any assets that can be pledged as collateral?
(Yes/No)
If yes, please indicate:
Personal Assets (Estimated value) - if none enter 0
Cash, checking and savings: $
Bonds, stocks, etc: $
Real estate (mkt. value): $
Automobile (mkt. value): $
Life Insurance: $ (cash surrender value)
Other Assets: $
Personal Liabilities: (Estimated)
Total credit card balance: $
Total mortgage balance: $
Total bank loan balance: $
Total student loan balance: $
Total auto loan balance: $
Other liabilities: $
Have you and/or the business ever filed bankruptcy? If yes, please explain.
If bankruptcy has been discharged, please provide the type and date of discharge
Do you have any collection items or unpaid taxes? If yes, please explain.
Do you have any pending police, public, or legal issues? If yes, please explain.
Are you or your business involved in any lawsuits? If yes, please explain.
Do you owe any outstanding child support? (Yes/No)
Have you ever defaulted on a federal government contract or student loan? (Yes/No)
Do you have proof of owner equity? (i.e. Cash to invest/receipts of business purchases) (Yes/No)
Do you have a written business plan with 2 years of cash projections? (Yes/No)
Are you a US citizen, or do you have a green card or other proof of residence? (yes/No)
Have you had 3 or more months of sales or do you have contracts for future sales? (Yes/No)
Do you or someone in your household have a secondary source of income? (Yes/No)
Did your business make a profit last year? (Yes/Mo)
Do you have formal training/experience in your field of business? (Yes/No)
Have you had any personal or business bank accounts with checks returned due to NSF? (Yes/No)
Do you own real estate (excluding your residence)? (Yes/No)
Are you currently paying off a vehicle purchase or lease? (Yes/No)
Is there another person who is willing to guarantee your loan? (Yes/No/or N/A-not applicable)
Will a credit report show that you have been current with creditors over the past 2 years? (Yes/No)
Have you addressed any derogatory statements on your credit report? (Yes/No)
I authorize PEZDC to make inquiries (via UCEDC) as necessary to verify the accuracy of the statements made and to determine my credit worthiness through a personal credit check. I hereby certify that all information contained in this document and any attachments is true and correct to the best of my knowledge.
Only applications completed in entirety will be considered.
The Federal Equal Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, nationals origin, sex, marital status, age (provided that 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 administrates compliance with this law concerning this creditor is the Federal Trade Commission, Equal Credit Opportunity, Room 500, 633 Indiana Avenue, N.W., Washington, DC 20580.
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