LOAN
REQUEST FORM
APPLICANT COMPLETE ALL AND RETURN BY FAX, EMAIL OR
DIRECTMAIL
|
TODAY’S DATE |
|
AMOUNT REQUESTED |
$ |
||||||||||
|
APPLICANTS NAME |
|
|
|
||||||||||
|
SS# |
|
DOB |
|
MOTHER'S MAIDEN NAME |
|
||||||||
|
ADDRESS |
|
COUNTY |
|
||||||||||
|
HOME PHONE# |
|
CELL PHONE # |
|
||||||||||
|
MARITAL STATUS |
|
MORTGAGE HOLDER NAME |
|
||||||||||
|
HOME VALUE $ (IF N/A THEN MONTHLY RENT PAYMENT) |
$ |
MORTGAGE BALANCE |
$
$ |
||||||||||
|
DRIVER'S LICENSE # |
|
STATE |
|
||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
EMPLOYER |
|
TITLE |
|
||||||||||||||||
|
IF SELF EMPLOYED: |
% OWNED |
|
DATE OF INC. |
|
STATE |
|
|||||||||||||
|
D & B # |
|
EIN # |
|
||||||||||||||||
|
ADDRESS |
|
||||||||||||||||||
|
PHONE # |
|
FAX # |
|
||||||||||||||||
|
ANNUAL INCOME |
$ |
OTHER ANNUAL |
$ |
||||||||||||||||
|
SOURCE OF ADDITIONAL INCOME |
|
||||||||||||||||||
|
IF SELF EMPLOYED: |
ANNUAL GROSS SALES |
$ |
ANNUAL LOSSES |
$ |
|||||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
HOW LONG EMPLOYED? |
□ YEARS |
□ MONTHS |
|
FAX # WHERE YOU CAN RECEIVE CONFIDENTIAL INFORMATION? |
FAX # 1 |
FAX # 2 |
APPLICANT ONLY APPLICANT ONLY
|
BANKING INFORMATION: |
TYPE OF ACCOUNT (BUSINESS/PERSONAL) |
|
|||||||||
|
BANK NAME |
|
ACCT. # |
|
||||||||
|
ADDRESS |
|
||||||||||
|
CONTACT PERSON |
|
PHONE # |
|
||||||||
|
CURRENT BALANCE |
$ |
AVG BALANCE |
$ |
||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
If you have an American Express Account number, have not ever been delinquent or
pastdue, or you have a Zero (0) balance with this lender, and your account
presently is in excellent standing; please provide your American Express Account
number in order for our agency to expedite faster processing of an approval for
your application. If you had a previous American Express Account and it
has not been used for a while, please note below and provide your number as
reference.
AMERICAN EXPRESS ACCOUNT # |
|
Applicant confirms that the information contained in the LOAN REQUEST FORM
is accurate, correct, and true to the best of his/her ability. Applicant
understands that submittal of this form is not a guarantee of credit and/or
an approval thereof, but constitutes the right of the Lender, its
affiliates, assigns, and assessors to review, process, and/or consider an
extension of credit to the Applicant whose signature appears below who meets
standard pre-approval requirements for funding per the request indicated.
Standard Application Fee of $895.00 is required to process this request for each
applicant applying up to $300,000 and $1,595.00 is required if funding placement
request is over $301,000. Applicant understands that he/she must provide a
Tri-Merge personal credit report in order to submit this request to the agency.
Otherwise, an $85.00 Credit Report Fee is required for each applicant applying.
(Make all payments by Cashier’s Check and/or Money Order to: ARTISTIC!
CAPITAL CORPORATION and return to Broker who provided the form to applicant or
fax directly in to the agency with your personal or business check.) By
directmail, we accept only Cashier's Checks and Money Orders for your placement
fee.
When finished submitting your payment, print out
this form and fax it immediately to: 1-866-784-7842 (24 hours per day, 7 days
per week). The Broker submitting this request will notify you immediately of
your approval and the amount you have pre-qualified for. If you are contacting
the agency directly, you will be notified within 24-48 hours of your
pre-approval status and whether your funding request has been pre-approved or
not. All application and processing fees are NON-REFUNDABLE at time of
submittal and will not be returned for any reason. To ensure the approval on
your application, please make certain that your personal Fico Score is at least
690-850 in order to be considered for Lines of Credit, Business Loans, Working
Capital Loans or Expansion Loans in the amount of $10,000 to $800,000.
Applicant Signature____________________________________
Date _____________________
If personal guarantor, please provide your
Signature above or if you are a Co-Signer for an application already in
progress.
If you require a CO-SIGNER, complete Co-Signer to complete section below where
indicated.
If a Business, additional
Officers signatures are required below:
______________________________ Title___________________ Date______________
Officer's Signature SS#: ___________________ DOB: ____________
______________________________ Title___________________ Date______________
Officer's Signature
SS#: ___________________ DOB: ____________
Broker of Record: __________________________________ Telephone #:
_________________
RETURN THIS FORM BY EMAIL
AND/OR FAX TO:
1-866-784-7842
(FAX 24 hours per day, 7 days per week)
AcctSrvs@artistic-capitalcorp.com
FAX INSTRUCTIONS:
1. Complete
form and fax to: 1-866-784-7842.
2. Write out your payment check for your personal credit report and
and your Application Fee, made payable to Artistic! Capital Corp.
and fax with your application. * DO NOT VOID YOUR CHECK *
3.
Download your Tri-Merge Personal Credit Report from our website
for less than $40.00 right now and return with your Loan Request Form.
4. You will be notified of the exact amount you are pre-approved for
within 24-48 hours of our receiving your Loan Request Form and
personal credit report payment.
5. If DECLINED for any reason or we cannot accept your request, we
will immediately return your payment the same day.
DIRECTMAIL YOUR REQUEST:
1. Complete application in its entirety and return with your personal
or business check as advised for your personal credit report fee.
2. Send by FEDEX, UPS, or Priority Mail, Next-Day Air Delivery
or Priority Mail for immediate processing. We process requests
by overnight services the fastest. (Regular Mail, will be processed
in the order in which it was received.)
3. Overnight or Mail
to:
Artistic! Capital Corporation
ATTN: PLACEMENT APPROVALS
1940 Deer Park Ave., Ste. #254
Deer Park, NY 11729-3328
©2000-2004 Artistic! Capital Corporation; ALL RIGHTS
RESERVED.