Applicant Information

Primary Applicant Info: Individual

First Name

Last Name

Social Security Number

Marital Status:

Married (includes separated)

Single (includes divorced, widowed and unmarried)

Are you a US Citizen or Permanent Alien:

Yes

Birth Date

Home Phone Number

Cell Phone Number

Applicant Email

Number of Dependants

Time at Resident

Present Address

Street Address

Street Address Line 2

City

State

Zip Code

Co-Applicant

Yes

Co-Applicant Information

First Name

Last Name

Cell Phone Number

Address

Address Line 1

Address Line 2

City

State

Zip Code

If Co-Applicant, provide relationship to primary applicant:

Application Information: Business Entity

Business Name

Federal Tax ID #

Business Address

Address Line 1

Address Line 2

City

State

Zip Code

Business Description

Percentage of Ownership

Principal/Officer Name and Title

Title

Principal/Officer Home Address

Address Line 1

Address Line 2

City

State

Zip Code

Loan and Property Information

Loan Amount

Desired Loan Product

Term (yrs)

Amortization (yrs)

Bare Land Only Value:

Permanent Planting Value (if applicable):

Improvement Value (include outbuildings & residence): $

Projected Loan-to-Value (loan amount/(bare land + permanent plantings)): %

Total Collateral Value: $

Source of Funds

Source of Funds Description

Amount

Source of Funds Total

Use of Funds

Use of Funds Description

Amount

Use of Funds Total

Total Source of funds should equal total use of funds. (Attach additional exhibits or descriptions as needed)

Is this financing related to any recent (12 month or less) land transactions? If so, please describe the terms of the land purchase, including purchase price:

Describe terms of recent land purchase:

General Business Information

Please provide a brief description (size and scope) of your current business operation:

At least one applicant must be a United States citizen or lawfully admitted alien to the U.S. who maintains permanent residence in the U.S. or a coporate entity or partnership whose members, stockholders, or partners holding a majority interest in the corporate entity or partnership are citizens or lawfully admitted aliens. The following list of questions applies to all applicants. Check all that apply.

Have you had a bankruptcy in the past 48 months.

Do you have any judgements against you?

Are you party to a lawsuit?

Have you had a property foreclosed or deed in lieu in the past 48 months?

Are any of the assets pledged as security for debts of others?

Do you have any contingent liabilities?

Have you endorsed or guaranteed notes for others?

Are you obligated to pay alimony or child support?

If Yes to any of the above please provide a written explanation to the for inclusion with this application:

Consolidated Balance Sheet

Financial Statements as of: (MM/DD/YYYY) (Within 90 days of application date is preferred)

Assets/Amount

Cash, Savings, Securities

Accounts Receivable

Crop Inventory

Market Livestock Inventory

Breeding Livestock Inventory

Machinery

Real Estate Market Value

Other

Total Assets

Liabilities/Amount

Operating Debt

Credit Card Debt

Accounts Payable/Trade Debt

Equipment Debt/Vehicle Debt

Long-Term Debt

Other Liabilities

Total Liabilities

Total Assets

Total Liabilities

Total Equity

Consolidated Income Statement

Most Recent Income Statement for Period beginning : (MM/DD/YYYY)

Most Recent Income Statement for Period ending : (MM/DD/YYYY)

Gross Farm Income

Net Farm Income (plus interest and deprciation)

Net Non-Farm Income

Total Net Income: (Net Farm + Net Non Farm)

Do you have a current operating Loan

Yes

Current Operating Lender

Years with Lender

Committed LOC Amount

Collateral - Irrigation Information

1. Is Your Property Irrigated?

Yes

1. Describe any water, irrigation, or well right/restrictions:

2. What is the source of water?

Groundwater/Well

Irrigation District

If Groundwater /well, what is the quantity (gallons per minute) and quality of the water?

3. Is the source located off the property?

Yes

If Yes, is a Water Use Agreement in place? (Please describe)

4. Is your property located in an irrigation district?

Yes

What is the irrigation district?

5. What percentage of the water supply is provided by the irrigation district and what percentage/cost is supplemented by water exchanges or ground water?

Irrigation District (%)

Supplement (%)

Supplement Cost: $

6. What is the quantity and quality of groundwater?

7. What is the quantity and quality of any exchange water?

8. What is the cost ($/acre foot) for the total water used on the proposed security?

Application for Crop Operating Loan

Application for Crop Operating Loan

Applicant Information

Primary Applicant Info: Individual

Co-Applicant Information

Application Information: Business Entity

Loan and Property Information

Source of Funds

Use of Funds

General Business Information

Consolidated Balance Sheet

Assets/Amount

Liabilities/Amount

Consolidated Income Statement

Gross Farm Income

Collateral- Property Information

Land Information

Collateral - Irrigation Information

Collateral - Improvements, Lease and Rental Agreement

Signatures and Authorizations

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