Commercial Loan Application

This Statement and any applicable supporting schedules may be completed jointly by both married and unmarried Co-Borrowers if their assets and liabilities are sufficiently joined so that the Statement can be meaningfully and fairly presented on a combined basis; otherwise, separate Statements and Schedules are required. If the Co-Borrower section was completed about a non-applicant spouse or other person, this Statement and supporting schedules must be completed by that spouse or other person also.

Borrower Personal Information
Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Email*
Home Phone
Cell Phone*
Date of Birth*
Date Format: MM slash DD slash YYYY
Social Security Number*
Name of Employer*
Address of Employer*
Street Address Address Line 2 City State ZIP Code
Business Phone*
Title or Position*
Type of Business*
Years on the Job*
Years in Profession*
Do you have a Co-Borrower?*
- Yes
- No
Co-Borrower Personal Information
Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Email*
Home Phone
Cell Phone*
Date of Birth*
Date Format: MM slash DD slash YYYY
Social Security Number*
Name of Employer*
Address of Employer*
Street Address Address Line 2 City State ZIP Code
Business Phone*
Title or Position*
Type of Business*
Years on the Job*
Years in Profession*

Personal Income Sources
Borrower and Co-Borrower Gross Salary Monthly*
Borrower and Co-Borrower Gross Salary Yearly*
Borrower and Co-Borrower Net Profit Monthly*
Borrower and Co-Borrower Recurring Rental Income Yearly*
Borrower and Co-Borrower Net Profit Yearly*
Borrower and Co-Borrower Recurring Rental Income Monthly*
Assets - Both Borrower and Co-Borrower (if applicable)
If you have a co-borrower, you must include their asset information
Cash Deposit towards purchase held by:*
Amount of Deposit towards purchase*
Bank Accounts*
Name and Address Of Bank, S&L or CU Account Number Cash or Market Value

Use the "+" to add additional accounts
Stocks and Bonds
Company Name Number Description Cash or Market Value

Use the "+" to add additional accounts
Life Insurance
Company Net Cash Value Face Value

Use the "+" to add additional accounts
Is there Owned Real Estate?*
- Yes
- No

Schedule of Real Estate Owned*

Property Address	Sold, pending, or rental?	Type of Property	Present Market Value	Amount of Mortgages and Liens	Gross Rental Income	Mortgage Payments	Ins., Taxes, Misc., & Maintenance costs total	Net Rental Income

Use the "+" to add additional accounts

Enter Total Market Value from Schedule of Real Estate Owned*
Amount of Vested Interest in Retirement Fund
Net Worth of businesses owned
Please include a financial statement for each business with your submitted documents
Automobiles owned
Year Make Value

Use the "+" to add additional accounts
Other Assets
Type of asset Value of Asset

Use the "+" to add additional accounts
Total of all assets*

Liabilities and Pledged Assets- Both Borrower and Co-Borrower (if applicable)
If you have a co-borrower, you must include their liability information List the creditor’s name, address and account number for all outstanding debts, including automobile loans, revolving charge accounts, real estate loans, alimony, child support, stock pledges, etc. Indicate those liabilities which will be satisfied upon sale of real estate owned or upon refinancing of the subject property.
Liabilities
Name and Address of Company Account Number Monthly Payment Months Remaining Unpaid Balance Will this debt be satisfied upon sale of real estate or refinance of subject property? Y/N

Use the "+" to add additional accounts
Alimony/Child Support/Separate Maintenance Payments owed
Owed to Payment Amount Term Remaining Unpaid Balance Will this debt be satisfied upon sale of real estate or refinance of subject property? Y/N

Use the "+" to add additional accounts
Job-related expenses
Expense Amount Frequency

childcare, union dues, etc. Use the "+" to add additional accounts
Total Liabilities*
Total of all unpaid balances
Total amount of Monthly Payments*
Total of all Assets*
Net Worth

Has the Borrower or Co-Borrower ever received credit under a different name?*
- Yes
- No
List all alternate names, appropriate creditor names and account numbers
Alternate Name Creditor Name Account Number

Use the "+" to add additional accounts

Vesting of Real Estate Title
List exact names of Individuals, Form of Title or Entity (one per line)*
Type of Entity*
- C-Corp
- S-Corp
- Partnership
- Proprietership
Ownership/Officers/Directors*
Name Title % Owned

Use the "+" to add additional accounts

Business Information
Business name
DBA - if applicable
Primary Address
Street Address Address Line 2 City State ZIP Code
Executive/Mailing Address
Street Address Address Line 2 City State ZIP Code
Business Website
Business Phone
Date Business Established
Date Format: MM slash DD slash YYYY
Number of Employees
Nature of Business
Business revenue (sales) trends in the last three years are:
- Increasing
- Decreasing
- Stable
Explain what factors have influenced your trends

Consent*
I/We consent and authorize Investment Capital Partners Kansas CIty per the statement below
I/We authorize Investment Capital Partners Kansas City and/or assigns to make inquiries as necessary to verify the accuracy of the statements made in this application and to determine my/our creditworthiness. I/We authorize and instruct any person or consumer reporting agency to compile and furnish any information it may have ot obtain in response to such credit inquiries. I/We certify the above and the statements contained in the attachments are true and accurate as of the stated date. These statements are made for the purpose of obtaining a loan. I/We understand FALSE statements may result in prosecution by the U.S. Attorney General (Reference 18 U.S.C 1001). I/We authorize the release of this information whether the signature below is an original or a copy.
Consent*
I agree sign this document digitally.
Borrower Signature*
Consent*
I agree sign this document digitally.
Signature*
Consent*
I/We agree to the privacy policy.
https://icpkc.com/privacy
Consent to communication from ICPKC*
I/We consent to receive communication from ICPKC
ICPKC will contact you about this application and possibly future products and services that they believe may fit your real estate funding needs and business.
CAPTCHA

Lender	Date Made	Original Amount	Current Balance	Term	Rate	SBA - Y or N

Name and Address Of Bank, S&L or CU	Account Number	Cash or Market Value

Company Name	Number	Description	Cash or Market Value

Company	Net Cash Value	Face Value

Year	Make	Value

Commercial Loan Application

Step 1 of 8

Borrower Personal Information

Co-Borrower Personal Information

Personal Income Sources

Assets - Both Borrower and Co-Borrower (if applicable)

Liabilities and Pledged Assets- Both Borrower and Co-Borrower (if applicable)

Information about property to be financed

Vesting of Real Estate Title

Business Information

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