IVCA Loan Program Application

IVCA would like to learn more about you and your loan needs. Although the information gathered here is not comprehensive of the information needed to make a loan decision, it does begin the initial screening process. If you would, please take a moment to fill in the information and submit it to our office. Someone will be contacting you soon to discuss moving forward.

APPLICANT INFORMATION
Company Name:
Type of Company:	(i.e. corporation, partnership, proprietorship)
Street Address:

City:	State: Zip:
County:
Phone Number:
Fax:
Email:

LOAN INFORMATION

Loan Request: (IVCA Portion)

Total Project Loan:

Is Your Business: New or Existing?

Specifically describe the use of the loan proceeds.
(i.e. purchase inventory, equipment, etc.):

Jobs to be Created:

Bank Name:

Contact Name:

Contact Phone:

VOLUNTARY INFORMATION
For Reporting Purposes Only

Gender of Company Principal(s):

Ethnicity of Company Principal(s):

IVCA is an equal-opportunity lender.