GATEWAY HARVEST, LLC
Send loan applications to:
Jerry McAdams, 504 Lake Ave, St. Louis, MO 63108 jlmcadam@swbell.net 314 454 1772
Your name: _____________________________ Name of business: _____________________________
Phone number: ____________________ Best time to reach you: _______________________________
Email: __________________________ Address: ____________________________________________
Executive Summary (one page, typewritten, please)
1. Your business: (Brief description, history, customer base, competition, number of employees,
who is the borrower – sole proprietorship, partnership, corporation)
2. Your personal and business background:
3. Your request for a loan: (Purpose, amount, period of time)
4. Do you have property and liability insurance? Yes ___ No ___
5. Have you or your business partners ever:
Been convicted of a felony? Yes ___ No ___
Filed for bankruptcy? Yes ___ No ___
Had any of your business property foreclosed upon? Yes___ No___
Are any lawsuits or administrative proceedings now pending or threatened against you or
your business? Yes ___ No ___
If any of the above is answered “Yes”, please provide details as an attachment.
In connection with my loan application to the Gateway Harvest Investment Club, LLC, I hereby
authorize the Gateway Harvest Investment Club to verify and collect credit information including, but
not limited to, bank references and trade and credit references.
Signature: ______________________________ Printed Name: ______________________________
Date: _________________________
1
CREDIT HISTORY
Business Loans
Name
Amount
Terms
Date of payoff
Personal Loans
Name
Amount
Terms
Date of payoff
Total monthly payments: $____________
People who can vouch for your credit worthiness (minimum of two)
Name: __________________________ Number: _____________________________
Name: __________________________ Number: _____________________________
Trade references (minimum of two)
Name: __________________________ Number: _____________________________
Name: __________________________ Number: _____________________________
Please attach a copy of your last two Income statements (Revenue, Expenses), balance sheet (Assets,
Liabilities) and your Business Income Tax forms (i.e., 1065 and/or Schedule F).
Please attach a copy of your Income (revenue, expenses) projections for the current or upcoming
year.
If you like to expand on our understanding of your business and need, please do so as an
attachment.
2