LBAI - Latin Business Association Institute

PHOTO REPRESENTING THE ACCESS TO CAPITAL SECTION

ACCESS TO CAPITAL > REFERRAL TO LENDER FORM

LOS ANGELES, CA
P (213) 628-8510
F (213) 628-8509

WELLS FARGO LOGO

UNION BANK LOGO

Download form in word format

Name:

Title:

Company:

Phone:

Fax:

Email:

Address:

City:

State:

Zip:

Type of Business:

Services	Technology
Construction	Wholesales/Retail
Manufacturing	Utilities
Finance	Insurance
Transportation	Real Estate
Public Administration
Other

Date Business Established:

Certified By:

Certified With:

City of Los Angeles

County of Los Angeles

CALTRANS

Metropolitan Transportation Authority (MTA)

Minimum Loan Amount $30,000

Amount Requested $
Purpose of Loan:

Net Profit from Business Operations for the last three years:

1999:
2000:
2001:

Additional Annual Household Income: $

THIS SECTION MUST BE COMPLETED:

Are you a legal resident or US Citizen?	Yes No
Are you on parole, probation or have a criminal record?	Yes No
Have you filed for bankcruptcy in the past seven years?	Yes No

ADDITIONAL QUESTIONS FOR START UP BUSINESSES:
Do you have good credit? (FICO 680+)	Yes No
Will you have a continual form of income other than the new business? What source?	Yes No
Do you have a business plan including projections?	Yes No
Do you have 30% of start up cost in liquid assets to infuse into the business?	Yes No

All questions above must have been answered with "YES" for start-ups.

I certify all the above information is accurate and has not been falsified at any moment. I authorize LBA/I to retain a credit report for the sole purposes of reviewing my credit to pre-qualify for a loan/credit.
Client Name: Date:

Latin Business Association Institute
5400 E. Olympic Blvd., Suite 130
Los Angeles, CA 90022
Telephone: (323) 721-4000
Fax: (213) 628-8509