CASTLE ROCK COMMERCIAL CAPITAL

BUSINESS LOAN QUESTIONNAIRE

Business name:

business address (physical): Business phone:

Business fax:

tax id number:

date business established:

Mailing address if different: State established:

Type of Business:

Number of Employees:

Employees If Approved:

By subsidiaries or affiliates:

Loan request:

loan amount: $ Expected closing date:

terms requested:

detail loan request:

purchase price: $

cash you are putting into the deal: $

What is the source of your cash infusion?

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business name:

ownership of applicant company:

name title SS# % Ownership

affiliates: list below all business concerns in which the applicant company or individuals listed above

own 20% or more of the affiliate company(s) listed below. Look at each above individuals' federal tax returns.

make sure all entities listed on the personal returns' schedule e's are accounted for.

company name owner title % Ownership

contact:

contact phone number:

contact e-mail address:

company web site: