Small Business Loan Gap Financing Program

Somerset County Business Partnership
Local Economic Stimulus through Small Business Resource Gap Loan Program

Smal Business Loan Submission Worksheet
$35,000 - $100,000 Gap Financing Loan Program

The Somerset County Business Partnership and participating financial institutions are collaborating on an initiative that will help expand Somerset County small businesses during the current economic downtown by providing loans that might not otherwise be available. The participation of many financial institutions will ensure a broader and more liberal program.

Print the application and fax it to 908-722-7823 or fill it out online.

Please provide the following information about you:

Borrower Name
Address
City
State/Province
Zip/Postal Code
Telephone
E-mail
Loan Request Amount
Use of Proceeds
Business start up/operation history (who, what and how)
New Business Startup	Yes No
Brief Resume
Personal Financial Information
Credit History (Commentary Paragraph on special situation or past problems including and liens)
Personal Net Worth (Composition of Net Worth, i.e. Real Estate)
Available Collateral
Personal	$
Business	$

Repayment Ability (Monthly Payment):	$

Additional Comments
In the event that the application does not qualify for a loan where it was presented, I hereby give permission for the lender to submit my application to the Somerset County Business Partnership's Small Business Gap Financing Loan Program.
Yes No