Purchase Loan Application First Name: Last Name: Email: Phone Number: Referred By: Home Address: Employer Name: Email: Phone Number: Ext: Business Address: Current annual income: Last years annual income: Loans require all borrowers to have a minimum credit score of 660. Can you meet these criteria? Yes No Equifax Credit Score: Experian Credit Score: TransUnionCredit Score: Farm Address: Contract Amount: Contract Expiration Date: Earnest Money Deposited: Is there a structure/home on the property? Yes No Will this be an Owner Occupied or Investor Purchase? Yes No Is the Farm in operations? Yes No If yes, will you continue the same grows? Yes No Is there a license or certification in place for the farm? Yes No Is the farm incorporated? Yes No If yes, will the sell include transfer of the corporation? Yes No Name of Corporation: Will the sell include transfer of the EIN? Yes No EIN: Type of Agricultural Property: Crop Ranch Dairy Permanent Planting Vegetables Poultry Swine Timber No AG Production Other How many acres is the subject property? Last two years of revenue from grows: Are there revenue contracts for the grows in place? Yes No Will they remain in place after the purchase? Yes No Type of crop to be grown: Years of Experience: Type of crop to be grown: Years of Experience: Type of crop to be grown: Years of Experience: Type of supplies to be purchased? Cost: Type of supplies to be purchased? Cost: Type of supplies to be purchased? Cost: Type of supplies to be purchased? Cost: Type of supplies to be purchased? Cost: Type of supplies to be purchased? Cost: Equipment to be purchased: Type of Equipment: Cost of Equipment: Number of Equipment: Total cost of Equipment: Purpose of Equipment: Invoice/Model Number: Supplier Name: Equipment to be purchased: Type of Equipment: Cost of Equipment: Number of Equipment: Total cost of Equipment: Purpose of Equipment: Invoice/Model Number: Supplier Name: Equipment to be purchased: Type of Equipment: Cost of Equipment: Number of Equipment: Total cost of Equipment: Purpose of Equipment: Invoice/Model Number: Supplier Name: What is the total amount requested? Corporate loans require established business credit and a minimum 3 years in business. Will you need a Corporate Loan? Yes No Is the Corporate Credit established? Yes No Will you be seeking an 8a certifications? Yes No If seeking a business loan, what is your repayment plan/exit strategy? Some loans may require a 30% minimum down payment - in cash or additional collateral. Can you meet these criteria? Yes No Are you seeking other business opportunities? Yes No If yes, please select your area of interest: Product Wholesale Retail Stores Testing Equipment Sales Industry Consulting Tours & Education 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. Submit