Market Microloan Application

List what you personally own and owe — or check the box if you have little to report.

The statements made in this application are for the express purpose of obtaining financing from Community Futures Thompson Country and are to the best of my/our knowledge true and correct.The applicant(s) understand that additional information may be required in support of this application and must be supplied before adequate consideration can be given to this application.The applicant(s) consent to Community Futures Thompson Country making any inquiries of such persons, firms or corporations as it deems necessary in order to reach a decision of this application.The applicant(s) agree to reimburse Community Futures Thompson Country any legal costs incurred in the registration of documents for loan security. Should the applicant withdraw this request for funds after legal documents have been registered and cost incurred, the applicant(s) shall be responsible for these costs.The applicant(s) understand that Community Futures Thompson Country is not acting exclusively for me or my venture, and that it reserves the right to provide financial and non-financial assistance to individuals or corporations which could be seen as my direct or indirect competition without further notice to me, as it may decide in its unfettered discretion.Under the Privacy Act and Oath of Confidentiality signed by all CFTC Directors, Committee Members and Employees, information collected and discussed will not be disclosed to any other party other than those required for the purpose of assisting and evaluating your business. By signing below, you understand our confidentiality policy and you consent to allow us to proceed on your behalf.I/we also confirm that I/we have approached my financial institute, relative to our application for financing, and have been unable to secure adequate financing under reasonable terms and conditions.I/We, the undersigned, consent to CFTC making any inquiries it deems necessary to reach a decision on this application, including but not confined to, reports from credit bureaus, retail credit companies and other sources deemed necessary and consent to the disclosure at any time of any credit information about me/us to any credit reporting agency or to anyone with whom I/We have financial relations.