Application - Agricultural Loans


Only Complete Applications will be accepted
* = Required Fields

Please tell us about yourself:

*Borrower Name
(exact legal name)

Co-Borrower Name
(exact legal name)

*Street Address of Operation

Address (cont.)

*City

*State

Zip/Postal Code

County

   

Current Mailing Address
(if different than Business Street Address)

Address (cont.)

City

State

Zip/Postal Code

County

   

Primary Business Contact

 

Phone Number

Fax Number

E-mail Address

   

Secondary Business Contact

Phone Number

Fax Number

E-mail Address

   

*Tax Payer ID Number:

Date Operation was Established:

(mm/dd/yyyy)

*Years Under Current Ownership

   

Specify Operation Type (may specify more than one)

Individual

Yearling

Hogs

Small Grains

Corporation

Feedlot

Sheep

Large Grains

Partnership

Pure Breeder

Horses

Other Crop

LLC

Cow/Calf

Other  


Please provide a brief description of the agricultural activity you engage in 
(size, # of head of livestock, etc)

 


Please provide the acreages of your operation:

Total Acres in Operation
(both owned and leased

Total Acres Rented

Pastureland Acres

Total Acres Owned

Total Acres Owned

Cropland Acres

Irrigated  Dryland



 

Ownership:  (List up to 5 using this application)

#1

 

Name (list all current owners)

Social Security #

Date of Birth

(mm/dd/yyyy)

Title (if applicable)

Owner Percentage

%

Number of years in this line of business

 

#2

 

Name (list all current owners)

Social Security #

Date of Birth

(mm/dd/yyyy)

Title (if applicable)

Owner Percentage

%

Number of years in this line of business

 

#3

 

Name (list all current owners)

Social Security #

Date of Birth

(mm/dd/yyyy)

Title (if applicable)

Owner Percentage

%

Number of years in this line of business

 

   

 

Financial Information (List up to 5 Deposit Accounts associated with the operation)
Operation Deposit Accounts

#1

 

Financial Institution
(Business Deposit Account)

Type of Account

Current Balance

$

Average Balance

$

Are you proposing to move the
account to BNC?

Yes No

#2

 

Financial Institution
(Business Deposit Account)

Type of Account

Current Balance

$

Average Balance

$

Are you proposing to move the
account to BNC?

Yes No

#3

 

Financial Institution
(Business Deposit Account)

Type of Account

Current Balance

$

Average Balance

$

Are you proposing to move the
account to BNC?

Yes No

#4

 

Financial Institution
(Business Deposit Account)

Type of Account

Current Balance

$

Average Balance

$

Are you proposing to move the
account to BNC?

Yes No

#5

 

Financial Institution
(Business Deposit Account)

Type of Account

Current Balance

$

Average Balance

$

Are you proposing to move the
account to BNC?

Yes No

   

Financial Information (List up to 5 current operational debts)
Operational Debts

#1

 

Financial Institution
(Business Deposit Account)

Type of Account
(revolving, term,etc..)

Current Balance Owed

$

Payment

$ per months
 

Pay off with proceeds from the business loan you are applying for?

Yes No

   

#2

 

Financial Institution
(Business Deposit Account)

Type of Account
(revolving, term,etc..)

Current Balance Owed

$

Payment

$ per months
 

Pay off with proceeds from the business loan you are applying for?

Yes No

   

#3

 

Financial Institution
(Business Deposit Account)

Type of Account
(revolving, term,etc..)

Current Balance Owed

$

Payment

$ per months
 

Pay off with proceeds from the business loan you are applying for?

Yes No

   

#4

 

Financial Institution
(Business Deposit Account)

Type of Account
(revolving, term,etc..)

Current Balance Owed

$

Payment

$ per months
 

Pay off with proceeds from the business loan you are applying for?

Yes No

   

#5

 

Financial Institution
(Business Deposit Account)

Type of Account
(revolving, term,etc..)

Current Balance Owed

$

Payment

$ per months
 

Pay off with proceeds from the business loan you are applying for?

Yes No

   
 

Loan Request #1

Requested Loan Amount

$

Requested Loan Term

years

Requested Interest Rate

%

Requested Payment Amount

$ per

Loan Type Requested

Purpose of the Loan

Other

Available Collateral:
(may choose more than one)

Cash Receivables

Marketable Livestock

 

Marketable Crops

Titled Vehicles

 

Cash / C.D.

Buildings

 

Publicly Traded Stock

Raw Land

 

Equipment

Farm Land

 

Growing Crops

Production Livestock

  Feed Other

Other

   

Loan Request #2

Requested Loan Amount

$

Requested Loan Term

months

Requested Interest Rate

%

Requested Payment Amount

$ per

Loan Type Requested

Purpose of the Loan

Other

Available Collateral:
(may choose more than one)

Cash Receivables

Marketable Livestock

 

Marketable Crops

Titled Vehicles

 

Cash / C.D.

Buildings

 

Publicly Traded Stock

Raw Land

 

Equipment

Farm Land

 

Growing Crops

Production Livestock

  Feed Other

Other

   

Loan Request #3

Requested Loan Amount

$

Requested Loan Term

months

Requested Interest Rate

%

Requested Payment Amount

$ per

Loan Type Requested

Purpose of the Loan

Other

Available Collateral:
(may choose more than one)

Cash Receivables

Marketable Livestock

 

Marketable Crops

Titled Vehicles

 

Cash / C.D.

Buildings

 

Publicly Traded Stock

Raw Land

 

Equipment

Farm Land

 

Growing Crops

Production Livestock

  Feed Other

Other

   

Please answer the following questions:

Has the operation or any owner ever declared bankruptcy? Yes No

If Yes, please describe:

   

Is the operation or any owner currently party to any claim or lawsuit? Yes No

If Yes, please describe:

 

Are there any tax liens filed against the operation or any owner? Yes No

If Yes, please describe:

   

Please provide any other information you feel is pertinent to the loan transaction:


   
Please read the terms below..... Click on Submit at the end of the documents to complete the application.  By submitting this application, all terms are accepted by the customer. 

I/We represent that this application is complete and accurate and fully reflects my/our financial condition on the date shown below.  I/We agree to notify Lender immediately, in writing, of any adverse change in my/our financial condition.  I/we understand that Lender will retain this Application whether or not it is approved.

INFORMATION DISCLOSURE AUTHORIZATION

To Whom it May Concern: 

I/We hereby authorize you to release to BNC National Bank its successors and/or assigns, for verification purposes, information concerning:

[ X ] Employment history, dates, title, income, hours worked, etc…

[ X ] Checking, savings, and investment accounts (including copies of statements, etc.).

[ X ] Mortgage/Consumer/Business loan rating, (opening date, high credit, payment amount, loan balance, and payment record).

[ X ] Personal and business records from accountants, attorneys, etc… that may have information required for the processing of a loan.

 [ X ] Any information deemed necessary in connection with a credit report for a mortgage/consumer/business loan transaction.

The information is for the confidential use of the lender in determining my/our creditworthiness for a mortgage/consumer/business purpose loan.

A PHOTOGRAPHIC COPY of the under sign's authorization MAY BE DEEMED TO BE THE EQUIVALENT OF THE ORIGINAL and MAY BE USED AS A DUPLICATE ORIGINAL.  The original signed form is maintained in the BNC NATIONAL BANK, 322 EAST MAIN, BISMARCK, ND 58501 OFFICE.

Your prompt reply will help my/our loan transaction.


Important Information

Procedures for opening a New Account
To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify and record information that identifies each person who opens an account.

What this means for you:
When you open an account, we will ask you for your name, address, date of birth, and other information that will allow us to identify you.  We may also ask to see your driver's license or other identifying documents.

Credit Disclosure Statement
Borrowers of BNC National Bank are not required to obtain insurance from a particular insurance company. Any insurance required as a condition of the extension of credit by BNC National Bank may, without affecting approval of the application for an extension of credit, be purchased from an insurance company of the Borrower's choice.



PRIVACY STATEMENT - Printable Copy

Revised: 08/15/2011

 

 

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