Please complete the following information and a representative will contact you as soon as possible regarding your application.
The information collected from this form will only be used by First Bank and its affiliates.
Contact Information:
Please give a brief description of your business:
What is the loan amount you are requesting? $ .00
How many years have you been in business?
Please give a brief description of how the loan proceeds will be utilized?
If the use of funds listed above does not include the purchase of real estate, do you own any real estate that you are willing to pledge as collateral for the project: Yes No
