GFS Investments

Information Regarding Business Only:

1. Loan amount Requested:

2. Referred by: at on - -

3. Exact name of business:

4. Nature of Business:

5. Business was formed in what State:

Date Business started:

- -

Legal formation of business:

EXAMPLE: Corporation ,LLC, Sole Proprietor, etc.:

6. Full Business address:

7. Business Telephone No: Business Fax No.:

8. Where does your business bank now? Name of bank

9. What is the business average monthly balance in business bank acct: $

10. What is the last 12 months business gross sales total: $

11. What is the last 12 months business profits before any taxes are paid: $

12. Business Federal Tax ID No.:

13. Has Business ever filed for Bankruptcy?
Yes No

14. Currently does the Business have any State/Federal Tax Liens?
Yes No

15. If yes explain for 12 or 13

16. Currently does the Business have any Business Judgments or Liens?
Yes No

17. If Yes explain

18. Your Business Attorneys name and address

19. Your Business Accountant name and address

Information Regarding Yourself As Personal Guarantor:

1. Your Full Name:

2. Full Address:

3. Home Phone No: Fax No:

4. Where do you personally bank, name of bank

5. What is your current bank balance: $

6. What is your gross salary before taxes: $

7. Your SS # Date of birth - -

8. Driver License # Exp. or Passport/State ID

9. Major Credit Card Acct # Exp.

10.Experian Credit Score

Provide a copy of your Credit Report if possible.
Yes No

11.Current Credit Card Debt $

Explain:

12.Have you ever filed for bankruptcy?
Yes No

13.Currently do you have any State/Federal Tax Liens?
Yes No

If Yes explain for 12 or 13

14.Currently do you have any Personal Judgments or Liens?
Yes No

If Yes explain:

Certification & Authorization to Release Information

The undersigned certify the following:
I/We completed a loan application containing various information on the purposes of the loan, employment and income information, and assets and liabilities. I/We certify that all of the information is true and complete. I/We made no misrepresentations in the loan application with the employer and/or other documents, nor did I/We omit any pertinent information. I/We have applied for a loan through GFS Investments and/or its affiliated banks. As part of the application process, GFS Investments and/or its affiliate banks. may verify information contained in my/our loan application and in other documents required in connection with the loan, either before the loan is closed or as part of its quality control program. A copy of this authorization may be accepted as an original.

Signature: