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  • Application Type *
  • Own/Rent
  • (if different from above)

Company Information

  • (Describe the products and/or services)
  • Entity Type *
  • Industry *
  • Have you been profitable for the past 3 years? *

Management/Ownership Information

  • Decision Maker
  • Actively Involved
  • Decision Maker
  • Actively Involved
  • Decision Maker
  • Actively Involved
  • Decision Maker
  • Actively Involved
  • Decision Maker
  • Actively Involved
  • Satisfaction *
  • Current Outstanding Loans

  • Credit Request

General Information

  • Do any of the owners listed on this application have an ownership, interest or continual liability in another company? *
  • Has the borrower or co-borrower used or done business under any other names? *
  • Has the borrower, co-borrower, owner or guarantor ever been convicted of a felony? *
  • Is the business an endorser, guarantor, or co-maker for obligations not listed on its financial statements? *
  • Is the business a party to any claim or lawsuit? *
  • Has the business ever declared bankruptcy? *
  • Does the business use hazardous substance in the normal course of business? *
  • Are any owners a Non-US Citizen? *
  • Is the applicant, or any officer, Principal or Partner of the applicant currently on the Board of Directors of a Bank, Thrift or S&L? *
  • May we contact the CPA?
  • May we contact the CPA?

The signer(s) certify that all information provided above is a complete and true statement of the financial condition of the undersigned individuals on the date indicated. The signer(s) authorizes Fowler State Bank ("Bank") to obtain consumer and/or business reports in their names as individuals at any time and to verify all portions of this financial statement, including all financial statements and federal tax returns, with appropriate sources. The Bank is also authorized to provide credit information about the signer(s) to other creditors and credit reporting agencies. The signer(s) also agrees to provide any further information the Bank may require to process this application.