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Initial Application for Revolving Loan Funds
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Business Name
First Name
Email
Last Name
Phone
Street Address
Street Address Line 2
City
Region/State/Province
Postal / Zip code
County
Clay
Craighead
Crittenden
Cross
Greene
Lawrence
Lee
Mississippi
Phillips
Poinsett
Randolph
St. Francis
Current Job Status
Employed
Unemployed
Are you a veteran?
Yes
No
Description of Business
Loan Amount Estimated
# of Employees before loan
# of Employees projected 1 year after the loan
Use of Loan Proceeds
Land Acquistion
New Consruction/Expansion/Repair
Purchase of Machinery & Equipment
Inventory Purchase
Working Capital
Collateral Available
I hereby certify that the information contained in this initial application is true and correct. By completing this initial application, you authorize EAPDD to share the information with other agencies.
Submit
Thanks for submitting!
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