$ Nutech Capital Resources $
General Loan Application
First Name:
Last Name: 
Company Name:
D.B.A.:
Your Title/Position:
Addrs:
City:
State:
Zip:
Phone:
Fax:
e-mail:
Business Structure: State
No. of Owners/Partners:
Purpose of Loan?
Amount Needed? $
When Needed?
How will it be collateralized?
Do you have ready access to the last 3 years of Business Federal and State tax filings?
Yes:
No: Explain:
Do you have ready access to the last 3 years of Personal Federal and State tax filings?
Yes:
No: Explain:
Bank References:
#1: Bank Ph: Contact:
Acct #: Type
#2: Bank Ph: Contact:
Acct #: Type
Trade References, if applicable:
#1: Business:
Ph: Contact: Acct.#:
#2: Business:
Ph: Contact: Acct.#:
#3: Business:
Ph: Contact: Acct.#:
Personal Information for Principals or Guarantors:
#1: Name:
Title: % of ownership: Soc Security #:
#2: Name:
Title: % of ownership: Soc Security #:
Please Note: No personal credit checks will be run without prior written approval.
Questions, Requests, Comments:

When completed please click on the submit button below:

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Nutech Capital Resources | P. O. Box 305, Brownsville | California | 95919 | USA
Ph: 530-675-9151 | Fax: 530-675-9152 | e-mail: Richard@NutechCapital.com

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