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| Small Business Loan Request |
| Please print this form. After completion, submit it to your Vision Mortgage Company loan officer. |
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Business History
| Company Name/Nature of Business: |
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| Types of Products/Services: |
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| Over what period of time: _________________ | Number of Locations: __________________ |
| How many new company locations are planned for this market?: | ||
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| How will this loan benefit your company? |
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| If so, state how: | ||
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| Customer Profile (Who are your target customers?): |
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| List Key Customers: | List Major Competitors: |
| _______________________________ | _______________________________ |
| _______________________________ | _______________________________ |
| _______________________________ | _______________________________ |
| Major Suppliers: | Geographical Sales Area: |
| _______________________________ | _______________________________ |
| _______________________________ | _______________________________ |
| _______________________________ | _______________________________ |
| Signature: _____________________________ | Date: __________________________ |