Date:___________

 

SHARE account #___________________________________________________

 

Amount and term of loan: $__________________for________________months

 

Name:____________________________________________________________

 

Home address:_____________________________________________________

 

Please feel free to use additional pages to answer any questions

 

Briefly describe your project:

 

 

Explain briefly how you anticipate that the use of this loan will provide any or all of the following benefits to the local community; 1) increase employment; 2) reduce dependency on outside sources of food, energy, building supplies, clothing or other basic necessities; 3) improve the quality of the environment; 4) provide a needed service or product to the community which is not either being provided at all, or which is inadequately provided at present – including social or cultural services.

 

 

 

If the loan application is not to an individual, explain the structure of your company or organization and describe any participation of members in decision-making. If a business, does it include participation in the ownership by workers or are there plans to do so?

 

 

 

 

PROJECT FINANCES

Funds are required for (purpose) :

 

a.__________________________________________________                           $_______

 

b.__________________________________________________                           $_______

 

c.__________________________________________________                           $_______

 

d.__________________________________________________                           $_______

 

e.__________________________________________________                           $_______

 

 

TOTAL FUNDS REQUIRED               $________________

 

Source of funds:

a. Loan from bank collateralized by SHARE                                                            $_______
b.__________________________________________________                          $_______

 

c.__________________________________________________                          $_______

 

d.__________________________________________________                          $_______

 

TOTAL FINANCING                           $________________

 

 

Current loans for project (use additional paper if necessary):

 

 

Name of lender, Security held, Repayment terms, and any Loan amount arrears:

 

 

 

 

 

Anticipated Project income for next year:

 

Gross $ _______________________________ Net $___________________________

 

Source of Income:    

 

a.__________________________________________               $___________________

 

 

b.__________________________________________               $___________________

 

 

c.__________________________________________               $___________________

 

 

Gross Project Income                            $________________

 

 

Anticipated Expenses for the next year:  

 

 

a.__________________________________________               $___________________

 

 

b.__________________________________________               $___________________

 

 

c.__________________________________________               $___________________

 

 

d.__________________________________________               $___________________

 

Total anticipated expenses for the next year   $ _______________

 

 

* Net Income from project with which to pay back loan

(Gross yearly income minus yearly expenses)                       $ ___________________