Loan Request - Individual SAGE Student
Business Information: / Business Name:
Date Started:
Individual Owner(s) Name:
Individual Owner(s) Address:
Individual Owner(s) Phone Numbers
Individual Owner(s) E-mail Address
How Much Money (in U.S. Dollars) Are You Requesting?
(Maximum: $100 for Individuals)
Purpose of the Loan:
How Would You Like to Pay the Loan Back After One Year from the Date the Loan Proceeds are Received?
___ In one lump payment, plus 5% interest
___ In four equal payments, payable at the end of each of the next four quarters after Year 1, using a 5% annual interest rate
___ In 12 equal payments, payable at each of each of the next twelve months after Year 1, using a 5% annual interest rate
Business Plan
In a separate attachment, please answer the following questions (if you have a formal business plan, include your plan, but make sure each of the following questions is addressed):
1. Please provide a brief history of your business, future plans and projections, and describe your products and/or services and competition.
2. Please describe your previous business experience. (Include business background, management experience, and training, or include a resume.)
3. What is your business’s competitive advantage? What makes it different?
4. At what price will you sell?
5. Where will you be selling your goods or services?
6. How will you advertise your business?
7. Are there any environmental concerns about your business?
8. Please include a projected balance sheet at the end of the first year; also include a projected income statement for your business for the first year.
9. Include a personal list of assets and liabilities (e.g., a personal balance sheet).
BUSINESS INFORMATIONBusiness Name
Address
Telephone ( )
Individual Name(s)
Address
Telephone ( ) / Date of Birth:
Proprietorship / Partnership / Sub-Chapter S / Corporation
Non-Profit / Individual / LLC
Ownership Distribution: (List partners, owner names) / Note: Attach separate sheet if additional space needed.
Name / Title / # of Months / %
Name / Title / # of Months / %
Name / Title / # of Months / %
Nature of Business / Date Established / Number of Employees
Months at Present Location / [ ] Own / [ ] Lease
FINANCIAL INFORMATION
Bank of Account (if any) / Account Number
Credit Relationships: Please provide details of your business credit relationships below:
Original Loan / Amount / Maturity
Name of Creditor / Purpose of Loan / Amount / Presently Owing / Repayment Terms / Date
$ / $
$ / $
$ / $
LOAN REQUEST
Amount of Loan Requested (in U.S. Dollars) / Type of loan
$ ______/ [ ] One year simple interest loan, with principal and interest payable at 5% at the end of loan contract is signed
[ ] One year installment loan, with principal and interest payable at an annual interest rate of 5% in four quarterly installments starting one year after the loan contract is signed
[ ] One year installment loan, with principal and interest payable at an annual interest rate of 5% in 12 monthly installments starting one year after the loan contract is signed
[ ] Other (to be negotiated)
Specific Loan Purpose (Check all that apply)
[ ] Working Capital / [ ] Other (State type of loan required and loan
[ ] Finance Purchase of Inventory / purpose)
[ ] Finance Purchase of Equipment
[ ] Finance Purchase of Real Estate
[ ] Finance Purchase of Business
[ ] Refinance Existing Loan or Debts
CERTIFICATION
The undersigned certifies that, to the best of his or her knowledge and belief, all information contained in this loan application and in the accompanying statements and documents is true, complete, and correct. The undersigned agrees to notify the SAGE Bank immediately of any material changes in this information
Business Name (print):
Applicant Signature(s): / Date:
Applicant Title:
SAGE Teacher or Advisor (s) Signature: / Date:
SAGE Country Coordinator Signature: / Date:
The SAGE Country Coordinator will submit the application to SAGE Headquarters for loan processing. If approved, we will forward a promissory note for you to sign. After this note is received by SAGE Headquarters, you will receive your loan proceeds within two weeks.