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Investors Group of East Gate LLC

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LOAN APPLICATION FORM

Borrower Information

First name*

Last name*

Business name (if applicable)

Business Address

Multi-line address

Country/Region

Address

City

Zip / Postal code

Phone number

Email address*

Date of birth*

Month

Day

Year

Social Security Number (for individual borrowers)*

Business Information

Type of Business Entity

e.g., Corporation, LLC, Sole Proprietorship, etc.

Year Established

Month

Day

Year

Federal Tax ID Number (EIN)

Business structure

Primary product/service offered

Website (if applicable)

e.g., www.igegllc.com

Financial Information

Loan Amount Requested*

e.g., USD$ 500,000

Proposed Use of Funds*

(Please outline how the funds will be used.)

Annual Revenue (Last 3 Years)

Year 1

Year 2

Year 3

Net Profit (Last 3 Years)

Year 1

Year 2

Year 3

Current Assets

Cash/Deposits

Accounts Receivable

Inventory

Other Assets

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