Banking and Finance Information Center

Banking and Finance Contact Form

Name

Email address

Phone number

Cellular or pager

Address

City

State

Zip

Business name

Business address

City

State

Zip

Business phone

Type of business

Number of years in operation

Is the business a sole proprietorship, partnership, corporation or limited liability company?

Is the business publicly held or privately held?

State of incorporation

Designated agent

Address

Financial History

Has company ever filed for bankruptcy?
Yes No

Description of loans currently held by company

Have any of these loans been through the Small Business Administration

Are there any judgments against the company? If yes, describe.

Are there currently any liens against company property or assets?

Number of employees

State employer tax identification number

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