Small Business Loan Inquiry Form

First Name:
Last Name:
Email:
Company:
Business Street:
City:
State/Province:
Zip:
Primary Phone:
Business Tax ID Number:

How is the Business organized?
Website:
Are you an existing customer of WaFd Bank?
Number of Employees:
Type of Request:
Desired Loan Amount:
Purpose of Credit Request:
If Other, Explain:
Collateral Description:
Collateral Value:
Existing Liens:
Date Business Established:
Present Management Since:
Description of Business Services:
Annual Revenue (From Last Tax Return):
Net Income (From Last Tax Return):
Current Bank:
Average Checking Balance:
Has the business incurred a loss in any of the last 3 years?
If yes, explain:
Does the business owe any taxes from prior years?
If yes, explain:
Is the business for sale or under agreement that would change the ownership of the business?
If yes, explain:
Is the business a party to any judgments, suits, or litigation?
If yes, explain:
Do you own another business?
If yes, explain:
Has any potential applicant declared bankruptcy in the last 10 years?
If yes, explain:
Are you party to any judgments, suits, or litigation?
If yes, explain:

Disclosures:

The person(s) signing on behalf of Applicant\Borrower certify that they are authorized to submit this application on behalf of Applicant\Borrower and that all information and documents submitted in connection with this application, including federal and state income tax returns (if any), are true, correct and complete. Applicant\Borrower authorizes Washington Federal ("the Bank”) to obtain consumer and business reports from others and to report credit information to others about the Applicant/Borrower and the Applicant's/Borrower's business. Applicant\Borrower agrees to notify the Bank promptly of any material change in such information. Applicant\Borrower acknowledges that additional information may be required in order for the Bank to make a final credit decision.

USA Patriot Act Notice:To help the government fight the funding of terrorism and money laundering activities, federal law requires all financial institutions to obtain, verify and record information that identifies each person who opens an account. What this means for you: When you open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver's license or other identifying documents.

Fair Credit Reporting Act Notice: Washington Federal is authorized to check my consumer credit report in conjunction with my application for/or guarantee of business credit.