Loan Application (Gas Station)

Your Name
Applicant/Borrower Company Name
Your Position/Title With Company
City & State
Owner's Name
Type of Ownership
Date of Incorporation
State of Incorporation
Is Your Company Public or Private? Public Private
If Public, Please Enter Symbol
Type of Business
How Long In Business?
Number of Stores
Franchise Affiliation, if any
E-Mail Address
Telephone
Facsimile
Company Website Address (If Any)
   
Do You Personally or Your Business Have Any Credit Problems? NoYes

If Yes, Please Explain
Has Your Company Been Profitable For The Last 3 Years? Yes No

If No, Please Explain
Any Lawsuits or Litigation Pending Against Borrower or Property? No Yes If Yes, Please Explain

ABOUT YOUR REQUEST

Applying For:

Amount Requested
Use of Funds
Desired Terms

ABOUT THE PROPERTY

Type of Property
Date Purchased
Purchase Price
Current Balance (all liens)
Market Value Real Estate Only
Market Value Going Concern
YTD & LAST THREE 3 YEARS INCOME & EXPENSE OF THE BUSINESS OR INCOME PROPERTY
  Sales Cost of
Sales		 Expenses Net Operating Income
YTD
2007 
2006 
2005
MOST RECENT BALANCE SHEET

(Not more than 60 days old)

Total Assets
Total Liabilities
Net Worth
HOW MANY OTHER LENDERS HAVE SEEN THIS DEAL?
HOW DID YOU HEAR ABOUT US? ----------------------------------->

(If Applicable) - General Comments or If You Have an
Executive Summary, Please Include Here
(You May Cut and Paste)
Thank you for your application. Because of the high volume of requests, we will only respond to requests that are accepted for further consideration. By submitting this online form, you understand that you are submitting this information for the sole purpose of assisting our Global Investment & Funding or its assigns with its initial consideration process, and in no way implies a commitment or obligation on the part of GIF or its assigns to consider your request or provide any financing or service. No oral representations made. You represent that the information provided on and with this form is true and correct, and that you are authorized to submit this form on behalf of the Borrower/ Applicant. Again, thank you, and we hope to be of service to you and your business.