Fishers Start-Up and Recovery Loan Application

Loan Information

Total Requested Amount*

Loans will not exceed $15,000.

Rationale for Request*

In a concise manner, please include additional reasons your company could benefit from this loan program and how the funds would be utilized if selected.

Applicant Contact Information

Contact Name*

Contact Email*

Contact Phone*

Mobile or Work Phone

Mobile

Required Documents*

Please upload the following: 1) Cover letter explaining your company's needs and additional information relevant to your request 2) Articles of Incorporation by the Secretary of State or

Drag and drop files here or

By Clicking on the Boxes Below, the Applicant agrees to the terms provided.

Applicant duly registered and in good standing with the Indiana Secretary of State’s Office.*

Applicant acknowledges that the Business Entity complies with Indiana's pubic access laws, and Borrower shall clearly and conspicuously mark all proprietary and confidential with the label “CONFIDENTIAL - PROPRIETARY INFORMATION”; however, without incurring any liability to Borrower, Foundation will ultimately determine which documents must be disclosed under Indiana law.*

Applicant acknowledges that the Loan Program is competitive, and applying for the Loan Program does not guarantee that Applicant will be selected for participation or receive any loan funds as a result of applying.*

None of Applicant’s directors, executives or leadership team is a public servant of the City of Fishers, including without limitation, serving on any board or commission of the City of Fishers.*

If selected for the Loan Program, Applicant agrees to participate in a paperless system, including without limitation, online bill payment, ACH deposit of funds, legal notices and communication with Lender by email, and electronic execution of promissory note.*

If selected for the Loan Program, Applicant agrees to execution of Foundation’s standard promissory note.*

On behalf of the Applicant and under penalties of perjury, I (person submitting application), hereby affirm that all information submitted in response to this application is true and correct.*

Date Submitted*

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Fishers Start-Up and Recovery Loan Application

Company Information

Loan Information

Applicant Contact Information

By Clicking on the Boxes Below, the Applicant agrees to the terms provided.