Loan Application

Required Loan Documentation

Complete Crop Loan Application Form
o Tax ID Number for all partnership/corporation owners
o Expected Crop Mix and Budgets
Copies of Driver’s License for all borrowers/guarantors
Copies of all current agricultural lease agreements
o Including legal descriptions
o Signed by Landlord and Tenant
Crop Insurance information
o APH Report
o Summary of Coverage/Schedule of Insurance
FSA payment information
o FSA 578’s
o Verification of any existing Assignment of Payments on file
Current Financial Statement signed and dated
o Equipment list with current values
o Schedule F from tax return (last 3 years)
Copies of all outstanding grain contracts
Verification of any other sources of income
o Custom harvest, haying, cattle
o W2’s
Harvest and Equipment agreements
List of all third-party credit
o Distributor
o Amount of credit
List of all prospective buyers for grain
For entity applicants/co-borrowers/guarantors please provide the following relevant
documentation:
o Organization documents
 Articles of organization
 Articles of incorporation
 Operating agreement
 Partnership agreement

First Name:

Last Name:

Referred By:

Address:

Work Phone:

Cell Phone:

Home Phone:

Email:

Date of Birth:

SSN:

Annual Income:

Equifax:

Experian:

TransUnion:

Have you filed bankruptcy?

Yes No

Are you past due on any debts?

Yes No

Co-Applicant Name: (at least 20% ownership)

Address:

Work Phone:

Cell Phone:

Home Phone:

Email:

Date of Birth:

SSN:

Annual Income:

Equifax:

Experian:

TransUnion:

Have you filed bankruptcy?

Yes No

Are you past due on any debts?

Yes No

Business Name:

Business AKA:

EIN:

Date of incorporation:

State of incorporation:

SIC Code:

NAICS Code:

Farm Address:

Phone Number:

Email:

Website:

Years in business:

Number of Employees:

Sales/Revenue last crop season:

Average bank balance (last 3 months):

Equifax Business Score:

Experian Business Score:

Dun & Bradstreet Score:

Paynet Score:

SBFE Reporting:

Have you or any affiliated entity filed a bankruptcy?

Yes No

Are you a defendant in any lawsuits or litigations?

Yes No

Are there any judgements pending against affiliated entities or yourself?

Yes No

Do you have 8A Certification?

Yes No

If yes, which certification do you have:

What Certifications does the business hold?

What Licenses does the business hold?

Do you have any loans with The U.S. Department of Agriculture’s (USDA) Farm Service Agency?

Yes No

If yes, are you current on all loans with The U.S. Department of Agriculture’s (USDA) Farm Service Agency?

Yes No

Are you receiving equipment collateralized loan payments from The U.S. Department of Agriculture’s (USDA) Farm Service Agency or any lenders?

Yes No

If yes, is the equipment factored into a loan?

Yes No

Are you eligible for federal farm loan programs?

Yes No

Do you have Federal Crop Insurance?

Yes No

If yes, with whom:

Are the Federal Crop Insurance premiums current?

Yes No

Are there any outstanding liens on the crops you're seeking funding for?

Yes No

If yes, with whom:

Are any of the future crops committed as collateral for repayments?

Yes No

If yes, with whom?

Are there any crop production loans provided by other lenders?

Yes No

If yes, with whom?

Are you receiving payments using a factoring company?

Yes No

If yes, with whom?

Do you farm your own crops?

Yes No

Do you harvest your own crops?

Yes No

Are your crops grown indoors or outdoors?

What percentage of your income is based on farming?

Do you have the necessary cash outlays, required for production and sell?

Yes No

Were your financials prepared by a CPA?

Yes No

Do you have the last three years of tax returns?

Yes No

Is there a home on the farm and is it owner occupied?

Yes No

What is the appraised Value of the Farm?

Is any portion of the land/ Farm leased?

Yes No

If yes, with whom?

Are you seeking other business opportunities?

Yes No

Upload all supporting documents below.

Authorization to Release Information

I/we hereby grant Agri-tech, Green Mills Growers and its Affiliates authorization of a credit inquiry and request disclosure of individual and corporate information, both written and oral for the purposes of Funding, Contracts, Marketing, Negotiations and or Business Development Services, including but not limited to: Crop Insurance Summary of Coverage, Schedule of Insurance, APH Reporting, Acreage Reporting, Settlement Sheets and/or Tickets, Grain or other Crop Contracts, Claim History, FSA information, FSA 156, FSA 509B, FSA 578, Farm Plans and Leases.

By typing your name here, you are signing this form electronically. You agree your electronic signature is the legal equivalent of your manual signature on this application.