Business Organization and Credit Information
Corporation

Complete separate form for the submitting corporation and the parent corporation (include all partners in a joint venture).

Name of Entity

 

Address

 

Telephone Number

 

Fax Number

 

Email Address

 

Contact Person

 

Title

 

Tax ID#

 

State of Incorporation

 

Date of Incorporation

 

 

OWNERSHIP

Number & Type of Shares or Percentage of Ownership

Current Value of Investment

Names & Addresses of those with controlling interest or key principals of corporation

 

 

 

 

 

Total of All

 

 

Total Shares
Outstanding

 

 

 


Corporate Officers and Board of Director

ADDRESS

Title and/or Affiliation

 

 

 

 

 

 

 

 

 

 

Credit Information

1) Has the prospective Tenant ever defaulted from or been terminated from lease, or been forbidden from contracting by a public agency or private company?

                                    □ YES                                                  □ NO

2) List any Foreclosures, Bankruptcies, Transfers in Lieu of Foreclosure and/or Work Out/Loan Modification Transactions during the past 10 years. (If none, so indicate).

 

Name of Property

City/State

Property Type

Approximate Loan Amount

Lender

Year of Event

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Attach an explanation of circumstances, including resolution, bankruptcy, plan, and/or other documentation as appropriate.

3) Describe any fines or penalties levied by government agencies during the past 10 years. (If none, so indicate).

4) Describe any pending litigation or current lawsuits (other than those covered adequately by insurance) which if adversely resolved would materially impact the financial position of the Prospective Tenant.

5) Attach:

i)  Personal Financial Statements of all owners, partners, and key principles of the parent company, if applicable. (Audited).

ii)  Latest Financial Statement for business for past 2 years. (Audited).

iii) Credit Reports for the entity and key principals, from a major credit reporting company such Equifax, Dunn & Bradstreet.