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Financing Application » General Financing

Business Information

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Business Name
DBA
Address
City
State
Zip
County
If using a DBA, what County was the Fictitious Business Name Statement filed?
If more than one place, list the counties, cities, and states where any and all business activities are conducted.
Type of Business
If a corporation, what State of Incorporation?
How did you hear about BH Capital?

Receivables

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Open Balance
$
Factored Before
Source
Approx. No. of Accounts
Terms of Sale
Average Mo. Sales Volume
$
Average Mo. No. of Invoices
Do any customers buy from you on a "Contra" account basis?
Type of Equipment to be Financed
Current Depreciated Value of Equipment
$
Current Market Value of Equipment
$
Value of Equipment to be Purchased
$
Appraised Value of Real Estate to be Financed
$
Purchase Price of Real Estate
$
Assets to be Pledged as Security for Line of Credit
Assets to be Pledged for Term Loan

Business Bank Account

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Bank Name
Type of Account
Address
City
State
Zip
Contact
Name of Attorney
Attorney's Telephone
( ) -
Name of Accountant
Accountant's Telephone
( ) -

Principal Suppliers

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Name
Telephone
( ) -
Name
Telephone
( ) -
Name
Telephone
( ) -
Are any assets now assigned, pledged or liened as collateral for loans?
If Yes, To Whom?

Personal Information - Owner or Officers - Residence

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Name
Title
Address
City
State
Zip
Telephone
( ) -
% Ownership
Own or Rent?
Driver's License #
State of Driver's License
Social Security Number
Date of Birth

Documents

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Please submit the following documents as is applicable to your financing request. The more complete the submission the more complete analysis BH Capital Ltd can give you and thus successfully complete your request. Please forward this information to:
BH Capital Limited LLC
2527 Virginia NE Suite J
Albuquerque, NM 87110
USA
Business Financial Statements (previous three years) Personal Financial Statements (previous three years)
Business Federal Tax Returns (previous three years) Personal Federal Tax Returns (previous three years)
Copy of DBA Filing and/or copy of Articles of Incorporation Accounts Payable Aging
Accounts Receivable Aging Customer list with name, addresses, zip codes and telephone numbers
One copy of completed invoice Note / loan and mortgage documents
Lease documents related to equipment and real estate Copies of all contracts
List (detail) of all accounts receivable with contract names and addresses List of all assets; machinery / equipment and inventory
Current real estate appraisal if applicable Incorporation papers/entity
Bylaws of the corporation All minutes of the corporation
All active employment / management and consulting agreements History of the corporation
Resumes of key management personnel Information on how the company markets its services
Description of future expansion and marketing Forecasts on revenues as prepared by management; 1-3 years with assumptions
Detail of any pending or current litigation Stock distribution to current shareholders and indicate consideration
Copy of all insurance policies: general business, workers comp, health, dental, etc. Company employee policies and procedures manual
Salary schedule of all employees Benefits package for employees and principals
List of competitors; addresses, telephone number, etc. All correspondence and statements on any IRS debt
Certificate of good standing Total shares authorized (common/preferred)
Total shares issued
In order to quickly determine if we can be of service to your firm, we need all of the information requested above as well as this completed application. If any information requested is not available, please attach a written explanation. All information will be held in strictest confidence. Please forward this information to:
BH Capital Limited LLC
2527 Virginia NE Suite J
Albuquerque, NM 87110
USA
Please tab each item in a comb or three ring binder along with index. We will begin review as soon as we receive the data in its entirety.

Almost Complete!

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By checking this box and entering your e-mail address in the space below, the undersigned certifies the following: That the information set forth in this application and in the documents, schedules, reports, statements, and/or other information provided to BH Capital Ltd with or pursuant to this application are full, true, correct and complete and accurately reflect such information on the date(s) thereof; that BH Capital Ltd is authorized to request, receive and verify credit reports and other financial information regarding applicant and its business that BH Capital Ltd deems necessary or appropriate; that BH Capital Ltd is authorized to inquire of, investigate, confirm, and verify any information contained in this application, in any documents, schedules, reports, statements and/or otherinformation provided under or pursuant to this application or learned by BH Capital Ltd as part of its investigation and review of this application, applicant, or applicant's business.
E-mail Address: