Vision Mortgage Company, Ltd.

Section 10 of 11
Small Business Loan Request
Please print this form. After completion, submit it to your Vision Mortgage Company loan officer.

Applicant Certification & Authorization

  Name of Applicant(s) ______________________ Type of Loan ______________________  
  Applicant certifies that this credit transaction is an "arm's length" transaction as defined by the U. S. Small Business Administration as follows:  
  "An arm's length transaction is between parties with adverse economic interest. Each party must be in a position to distinguish his or her economic interest from that of the other party, and where they conflict, choose that interest that is to his or her individual benefit."  
  Applicant is aware that Lender is relying on the information provided by Applicant including, but not limited to: tax statements, financial reports, business records, environmental information, information described in exhibits or attachments to the Application and any other information provided to Vision Mortgage Company, Ltd. or the Associates Small Business Financing Division for the evaluation and processing of Applicant's credit transaction to determine eligibility for this loan. If Applicant is found to have provided false information or failed to provide known information in this transaction, such action will be considered an adverse change to the loan and will result in the cancellation of the loan commitment, as well as other additional action, where appropriate.

Applicant hereby authorizes the release to Vision Mortgage Company, Ltd. and the Associates of all credit history* and information required by Vision Mortgage Company, Ltd. or the Associates for the purpose of processing and evaluating Applicant's credit transaction. Applicant also permits Vision Mortgage Company, Ltd. and the Associates to release his or her credit information and otherwise exchange information regarding Applicant's credit transaction to various business professionals involved in Applicant's portion of the transaction including, but not limited to, commercial real estate brokers, real estate agents, accountants and attorneys as well as to any other entity Vision Mortgage Company, Ltd. or the Associates deem necessary for any reason related to Applicant's credit transaction.

Applicant acknowledged that all loan approvals will be in writing and subject to terms and conditions set forth in a commitment letter signed by an officer of Vision Mortgage Company, Ltd. or the Associates.

Applicant certifies under penalty of perjury under applicable state and federal laws that the foregoing, the Application and any information or documentation Applicant has provided Vision Mortgage Company, Ltd. or the Associates is true and correct to the best of Applicant's knowledge and that the signature(s) placed below are the signature(s) that Applicant commonly uses in all the applicant's business transactions.

  Signature of Applicant: ____________________ Date: ______________________________  
  Home Address: _________________________ Social Security Number: _______________  
  Signature of Applicant: ____________________ Date: ______________________________  
  Home Address: _________________________ Social Security Number: _______________  
  *You may obtain your own copy of your credit report prior to applying for a loan for a small fee from any of the credit reporting agencies. For more information call Equifax at (800) 685-1111, Trans Union at (800) 916-8800 or Experian (formally TRW) at (800) 682-7654. In the event that your application is denied as a result of an agency's report, if you contact the agency that issued the credit report at the appropriate number listed above within 60 days of the issuance of the report, the fee for the credit report may be waived pursuant to applicable laws and regulations.  
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