Commercial Credit Application (For Tenants)

RENTAL/CREDIT APPLICATION & CREDIT REPORT RELEASE FORM
The following information is provided to the Landlord for the purpose of verifying Credit History of the named applicant.
FULL NAME__________________________________________________________________________
DATE OF BIRTH____________________________________STATE_________________
SOCIAL SECURITY #________________________________
HOME ADDRESS_________________________________CITY______________STATE_____ZIP___________
HOME PHONE:__________________________FAX: __________________________
BUSINESS PHONE: __________________________FAX: __________________________
PREVIOUS ADDRESSES WITH ZIP CODES (IF LESS THAN 3 YEARS AT PRESENT ADDRESS)
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
___________________________________________________________________________________________________
DRIVER’S LICENSE # OF APPLICANT_________________________STATE______
___________________________________ _______________________
Signature Date
CO-APPLICANT (if any)____________________________________________________________
DATE OF BIRTH____________________________________STATE_________________
SOCIAL SECURITY #________________________________
HOME ADDRESS_________________________________CITY______________STATE_____ZIP___________
HOME PHONE:__________________________FAX: __________________________
BUSINESS PHONE: __________________________FAX: __________________________
PREVIOUS ADDRESSES WITH ZIP CODES (IF LESS THAN 3 YEARS AT PRESENT ADDRESS)
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
___________________________________________________________________________________________________
DRIVER’S LICENSE # OF APPLICANT_________________________STATE______
___________________________________ ______________________
Signature Date
Application Authorization:
This is to clarify that all information provided in this Credit Application is, to the best of my (our) knowledge, accurate and truthful. I (we)
authorize Great American Capital to investigate and verify all information through a Credit Report or other inquiry.
PAGE 1 OF 5
CONFIDENTIAL FINANCIAL STATEMENT
Name _________________________________________ Social Security # _______________________________
Address _________________________________________ Business Ph ________________________________
_________________________________________________ Residence Ph ________________________________
Occupation ____________________________________ Employer ________________________________
Employer’s Address _____________________________________________________________________________________
Spouse’s Name _________________________________ Social Security # ________________________________
Address _________________________________________ Business Ph ________________________________
_________________________________________________ Residence Ph ________________________________
Occupation _________________________________ Employer ________________________________
Employer’s Address _____________________________________________________________________________________
ASSETS
ALL LIQUID ASSETS MUST BE ACCOMPANIED BY VERIFICATION
Cash (other than amounts shown in banks) $_________________ Automobiles $_________________
Cash in Banks (Schedule 1) $_________________ Other investments (Schedule 3) $_________________
Accounts Receivable (Schedule 2) $_________________ Personal Property $ ______________
Notes Receivable (Schedule 2) $_______________ Net Worth of any Business Owned
Stocks and Bonds (Schedule 3) $_______________ (Please include financial statement) $______________
Real Estate (Schedule 4) $_________________ Other Assets $________________
Sub Total $_______________ Sub Total $______________
Total $______________
LIABILITIES
Notes Payable to Others (Schedule 7) $_________________ Loans Against Life Insurance $_________________
(Schedule 6)
Installment Loans Payable (Schedule 7) $_________________ Other Liabilities $_________________
Accounts Payable $_________________ Liens on Real Estate (Schedule 5) $ ______________
Taxes Payable $_________________ Long Term Debts $_________________
Sub Total $_______________ Sub Total $______________
Total $______________
Net Worth $______________
Salary $_________________ Taxes & Assessments $_________________
Spouse’s Salary $_________________ Income Taxes $_________________
Dividends $_________________ Child Support/ Alimony $ ______________
Interest $_________________ Mortgage Payments $_________________
Commissions $________________ Contract Payments $_________________
Rentals $_______________ Insurance $_______________
Other $_______________ Other $_______________
Total $_______________ Total $_______________
PAGE 2 OF 5
SCHEDULE OF ASSETS
Schedule 1 Cash in Banks & Savings and Loan & Checking Accounts **
Bank Name 90 Day Avg Balance Account # Balance
Total $_______________
**For each account, submit a verified statement from each banking institution, to include Name of Account, Current Balance, Account
Number, Length and Specific Dates of Account. The accounts must have been open and on deposit for a minimum of ninety (90) days
prior to the date of application.
Schedule 2 Receivables
Name of Debtor Collateral Payments Maturity Date Unpaid Balance
Total $_______________
Schedule 3 Stocks and Bonds
# of Shares Description Amount Carries on My Books Presents Market Value
Total $_______________
Schedule 4 Real Estate (If additional space is necessary, attach separate sheet)
Address of Legal Description Type of Property Monthly Income Original Cost Estimated Present Value
Total $_______________
Schedule 5 Mortgages of liens on Real Estate
Name of Creditor Payments Unpaid Balance
Total $_______________
Schedule 6 Cost of Maintaining Office
Rent __________________ Utilities __________________
Telephone __________________ Clerical Help __________________
Other (Describe) __________________
Sub Total Sub Total
Total $_______________
Schedule 7 Notes Payable to Others
Name of Creditor Address Payments Collateral Unpaid Balances
Total $_______________
I, by signing and filing this application, authorize any person or institution to which reference is made be me is connection with the
application, to release or divulge to the Landlord or its representative any information I the possession of such person or institution
regarding me. I hereby approve any investigation on my credit background.
Signature _____________________________________________ Date _______________________________
PAGE 3 OF 5
PROSPECTIVE TENANT QUESTIONNAIRE
Please complete in full. If you need more space to respond to any of the questions, please continue of a separate sheet of
paper.
Individual(s) ____________________ Corporation ____________________ LLC ____________________
What kind of business do you propose to operate at the center?
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
What is your current profession?:__________________________________________________________________________________
What is your spouse’s current profession?:__________________________________________________________________________
Will either you or your spouse be leaving your current position to operate this business?
____________________________________________________________________________________________________________
How will you operate your new business at the proposed location? Who will manage? How many employees will you have?
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
What is your experience at operating such an enterprise? (Please provide specifics)
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
What improvements do you plan to make to the Premises (fixtures, carpet, etc.) and what cost? How will you pay for these
improvements?
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Describe your anticipated start-up operating expenses at the new location and list amounts (include inventory, supplies, initial payroll
costs, insurance, signage, etc. (attach additional sheet if more room is required to answer these questions.)
_____________________________________________________________________ $__________________________
_____________________________________________________________________ $__________________________
_____________________________________________________________________ $__________________________
_____________________________________________________________________ $__________________________
_____________________________________________________________________ $__________________________
_____________________________________________________________________ $__________________________
_____________________________________________________________________ $__________________________
Total Start-Up Expenses: $__________________________
PAGE 4 OF 5
How will you pay for your start-up expenses?
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Do you have any other comments of information that you feel the Landlord should take into account in evaluating your proposed store or
restaurant?
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
PAGE 5OF 5

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RENTAL/CREDIT APPLICATION & CREDIT REPORT RELEASE FORM

SOCIAL SECURITY #________________________________

HOME PHONE:__________________________FAX: __________________________

BUSINESS PHONE: __________________________FAX: __________________________

DRIVER’S LICENSE # OF APPLICANT_________________________STATE______

CO-APPLICANT (if any)____________________________________________________________

SOCIAL SECURITY #________________________________

HOME PHONE:__________________________FAX: __________________________

BUSINESS PHONE: __________________________FAX: __________________________

DRIVER’S LICENSE # OF APPLICANT_________________________STATE______

Name _________________________________________ Social Security # _______________________________

Address _________________________________________ Business Ph ________________________________

_________________________________________________ Residence Ph ________________________________

Occupation ____________________________________ Employer ________________________________

Employer’s Address _____________________________________________________________________________________

Spouse’s Name _________________________________ Social Security # ________________________________

Address _________________________________________ Business Ph ________________________________

_________________________________________________ Residence Ph ________________________________

Occupation _________________________________ Employer ________________________________

Employer’s Address _____________________________________________________________________________________

Cash (other than amounts shown in banks) $_________________ Automobiles $_________________

Cash in Banks (Schedule 1) $_________________ Other investments (Schedule 3) $_________________

Accounts Receivable (Schedule 2) $_________________ Personal Property $ ______________

Notes Receivable (Schedule 2) $_______________ Net Worth of any Business Owned

Real Estate (Schedule 4) $_________________ Other Assets $________________

Sub Total $_______________ Sub Total $______________

Installment Loans Payable (Schedule 7) $_________________ Other Liabilities $_________________

Accounts Payable $_________________ Liens on Real Estate (Schedule 5) $ ______________

Taxes Payable $_________________ Long Term Debts $_________________

Sub Total $_______________ Sub Total $______________

Net Worth $______________

Salary $_________________ Taxes & Assessments $_________________

Spouse’s Salary $_________________ Income Taxes $_________________

Dividends $_________________ Child Support/ Alimony $ ______________

Interest $_________________ Mortgage Payments $_________________

Commissions $________________ Contract Payments $_________________

Rentals $_______________ Insurance $_______________

Other $_______________ Other $_______________

Total $_______________ Total $_______________

Signature _____________________________________________ Date _______________________________

Individual(s) ____________________ Corporation ____________________ LLC ____________________

What kind of business do you propose to operate at the center?

What is your current profession?:__________________________________________________________________________________

What is your spouse’s current profession?:__________________________________________________________________________

What is your experience at operating such an enterprise? (Please provide specifics)

Total Start-Up Expenses: $__________________________

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HOME PHONE:FAX:

BUSINESS PHONE: FAX:

DRIVER’S LICENSE # OF APPLICANT___________________STATE

HOME PHONE:FAX:

BUSINESS PHONE: FAX:

DRIVER’S LICENSE # OF APPLICANT___________________STATE

Name ___________ Social Security # _

Address _________ Business Ph

_________________ Residence Ph

Occupation ____ Employer

Spouse’s Name _ Social Security #

Address _________ Business Ph

_________________ Residence Ph

Occupation _ Employer

Cash (other than amounts shown in banks) $_ Automobiles $_

Cash in Banks (Schedule 1) $_ Other investments (Schedule 3) $_

Accounts Receivable (Schedule 2) $___ Personal Property $

Real Estate (Schedule 4) $_ Other Assets $

Sub Total $_ Sub Total $

Installment Loans Payable (Schedule 7) $_ Other Liabilities $_

Accounts Payable $___ Liens on Real Estate (Schedule 5) $

Taxes Payable $_ Long Term Debts $_

Sub Total $_ Sub Total $

Salary $_ Taxes & Assessments $_

Spouse’s Salary $_ Income Taxes $_

Dividends $___ Child Support/ Alimony $

Interest $_ Mortgage Payments $_

Commissions $ Contract Payments $_

Rentals $_ Insurance $_

Other $_ Other $_

Total $_ Total $_

Signature _______________ Date _

Individual(s) Corporation LLC