OFFICIAL
CHURCH INFORMATION
Legal Name Of The Church:
Church Address:
Phone
Number :
FAX
Number:
City :
State :
Zip
Code :
E-Mail Address:
Website:
Denomination Affiliation:
Date Of Organization:
Date Of Incorporation:
Federal Tax ID Number:
LOAN
PURPOSES
Total
Amount of Loan Requested:
Construction
Cost:
Property
Purchase Cost:
Refinance
Cost:
Is
there any type of financing unacceptable to your Church?
(For Example: Private Investors, Insurance Companies, Bonds, Notes, Banks,
Joint Partnerships)
No
Yes
If
yes, which type is unacceptable?
PASTOR
/ MINISTER INFORMATION
Pastor
/ Minister:
Title:
Home
Phone Number:
CONTACT
PERSON INFORMATION
Contact
Person:
Title:
Home
Phone Number:
Business
Phone Number:
Mobile
Phone Number:
FAX
Number:
E-Mail
Address:
Best
Time And Place To Contact:
CPA
/ ACCOUNTANT INFORMATION
CPA
/ Accountant:
Phone
Number:
FAX
Number:
Address:
City :
State :
Zip
Code :
Best
Time And Place To Contact:
FINANCIAL
HISTORY / PROFILE
Has
the Church been involved in any litigation within the past ten years?
No
Yes
Is
the Church aware of any pending or future litigation?
No
Yes
Has
the Church ever defaulted on a previous bond issue, loan, or mortgage?
No
Yes
Are
there any contracts, if terminated, would affect the Church s income?
No
Yes
Does
the Pastor or any other staff member in a leadership position intend leaving
the Church before the funding of this loan?
No
Yes
Is
the Church currently or in the past in default of any financial liability?
No
Yes
Has
The Church ever issued Bonds?
No
Yes
Has
The Church ever issued personal notes?
No
Yes
Approximate
Value of Existing Properties:
Amount
of Current Debt to be Paid Off:
Purchase
Price of New Property:
Approximate
Value of New Property:
OUTSTANDING
LOAN DETAIL (Land & Buildings Only)
Debt 1
Debt 2
Debt 3
Debt 4
Present
Balance:
Monthly
Payment:
Original
Loan Amount:
Date
Started:
Length
Of Debt:
Rate
Of Interest:
Item
Purchased:
CHURCH ATTENDANCE
INFORMATION
Year
Sunday AM Worship
Members
Members Under Age 18
Number Of Families
2006
2007
2008
2009*
Church
Fiscal Year Begins:
January
February
March
April
May
June
July
August
September
October
November
December
*Number
Of Months To Date:
0
1
2
3
4
5
6
7
8
9
10
11
12
PLEASE PROVIDE THE FOLLOWING IMPORTANT
INFORMATION
*The Financial Analysis Cannot Be Completed
Unless the Following Required Documentation Is Provided
FAX (206) 888-4157
1. Financial
Statements for the past three years plus current year period.
2. A brief history of The Church.
3. A brief resume or narrative history of the Senior Pastor/Minister.
The Church
certifies that it understands that Loan Underwriting approval is subject to a
due diligence investigation by The Church Lending Group and / or its
Lending Sources and cannot be completed until all required documentation has
been submitted and verified. If the Church is approved for Loan Underwriting,
the following will be required:
Application fee
of $3,500 which will cover in part an appraisal of all Real Estate used as
collateral and Environmental Phase I Report.
By submitting
this form, I certify that all information contained herein is true and
accurate to the best of my knowledge.
Prepared
By:
Date: