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BUSINESS LOAN APPLICATION

February 01, 2012 Re: Loan Application In an effort to obtain a loan from your institution, the undersigned present(s) the following information as an application for an extension of credit. If you have any additional questions or need further information to supplement this application, please feel free to call the undersigned at your convenience. Name of Business: Contact person: ABC Widgets Javier Espinoza 8 Hayes St Big City, CA 94901 Phone: 415-454-1413 Ext.: 234 Sole proprietorship manufacturing and distributing widgets.

Type of Organization: Nature/Line of Business: Key Owners/Officers: Name: Title: Address:

Javier Espinoza CEO 12 H St Big City, CA 94901 Phone: 415-645-6634 Ext.:2345 4 years four years $75,000.00

Length of time in business: Time under current management: Owner's cash or other equity invested:

Current Loan Request 1. Amount of loan: 2. Type of loan: 3. Interest rate: $25,000.00 Term loan 3.5%

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4. Term: a. Beginning date: February 24, 2012 b. Number of payments: 12 5. Repayment schedule: Monthly payments The purpose for the loan request: for capital improvements to production facilities. Source of repayment: Available collateral: Guarantor(s): General business earnings Parking Lot A

Borrowing History Other Lender: Address: Phone: Date of loan: Amount borrowed: Current balance: Business Plan: Attached documents: Susan Rose 133 25th St Big City, CA 94901 415-456-4454 February 04, 2009 $10,000.00 $0.00 Attached Financial statements References Name: Address: Phone: Relationship: Ben Green 99 12th St Big City, CA 94901 415-343-3435 loan adviser of prior loan

An attached Authorization Letter has been included to assist you with the verification process.

Applicant: ABC Widgets

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By: __________________________________ James Smith CEO

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VERIFICATION AUTHORIZATION

February 01, 2012 ABC Widgets To Whom It May Concern: ABC Widgets ("the Applicant") has applied for a loan with Jim Cruz ("the Lender") on February 20, 2012. The Lender is authorized to obtain all information that it determines is necessary for consideration of the loan application. The information requested may include credit history, bank deposits and other financial information. In order to assist with this loan request, we ask for your cooperation in providing all requested information as soon as possible. Your prompt response will help us receive an answer regarding the approval of the loan in a timely manner. In exchange for your efforts, we release you, your officers, directors, employees, and representatives from and agree to hold all of the above harmless against any and all claims, liabilities, lawsuits, damages, costs and expenses arising out of your cooperation. A photocopy of this letter will be treated as an original copy and will provide you with all of the protections of the original. Thank you for your cooperation.

Applicant: ABC Widgets

By: _____________________________ John Thompson Administrative Assistant

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