McQue Capital - Allstate Insurance Agency Loans & Financing

Allstate TPP Loan Application


 

BORROWER'S INFORMATION

Borrower

Address

 

 

Residential Status

Monthly Payment

SSN

Date of Birth

Mothers Maiden Name

Credit Score

Bankruptcy

Lawsuit

 

CO-BORROWER'S INFORMATION

Co-Borrower

Address

 

 

Residential Status

Monthly Payment

SSN

Date of Birth

 

Mothers Maiden Name

Credit Score

Bankruptcy

Lawsuit

 

AGENCY INFORMATION

Agency Name

Tax I.D.

 

 

Agency Address

Business Phone

 

 

Exact Name on Allstate R3001 Agreement

Allstate Agent ID

 

 

TPP Value (Vested)

TPP Value (In-Vesting)

Annual Revenue

Agency Value

Supporting Documents:

 

Business Type

Agency History

Date Established

Date of Purchase

 

Years of Experience

# of Employees

# of Producing Staff

# of Support Staff

Existing Lien

Lender

Rate

Maturity

Secondary Lien

Lender

Rate

Maturity

 

 

LOAN INFORMATION

Requested Loan Amount

Preferred Term(s)

 

 

Use of Proceeds:

 

 

 

DISCLAIMER

 

By providing your phone number, address, and email on the previous pages you are authorizing McQue Capital and/or its funding sources to contact you via these methods. The information contained in this statement is provided for the purposes of obtaining or maintaining credit on behalf of the undersigned or of the guarantee of debt by the undersigned. Each undersigned understands that McQue Capital and/or its funding sources are relying on the information provided herein (including the designation made as to ownership of property) in deciding to grant or continue credit. Each undersigned represents and warrants that information provided is true and complete and that McQue Capital and/or its funding sources may consider this statement as continuing to be true and correct until a written notice of change is given to McQue Capital and/or its funding sources by the undersigned. I/we authorize McQue Capital and/or its funding sources to make all inquiries deemed necessary to verify the accuracy of the statements made herein, and to determine my/our creditworthiness, including, without limitation, obtaining consumer credit reports and investigative reports on me/us, and to answer questions and share or disclose to our funding sources, information and documents relating to my/our credit experience.

 

As an authorized representative of the Applicant, I certify that all information provided herein and any supporting documentation with this application are true and correct. McQue Capital and/or its funding sources may check credit and trade references in reviewing this application and disclose information about its credit experience with the Applicant. For the review of this application as well as for the servicing, collection, renewal or extension of the resulting financing, if any, McQue Capital and/or its funding sources may also inquire as to and obtain credit reports on the undersigned owner(s), guarantor(s) and other principals. Note: All guarantors must sign below.

 

If your application for business credit is denied, you have the right to a written statement of the specific reasons for denial. To obtain the statement, please contact McQue Capital, LLC, PO Box 903, Gretna, NE 68028 or (877) 432-7030, within 60 days from the date you are notified of our decision. We will send you a written statement of reasons for the denial within 30 days of receiving your request for the statement. To receive a copy of your credit report, please write Experian, P.O. Box 2002, Allen, Texas 75013, or call 1-888-397- 3742.

 

NOTICE: The federal Equal Credit Opportunity prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national origin, sex, marital status, age (provided the applicant has the capacity to enter into a binding contract); because all or part of the applicant's income derives from any public assistance program; or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act.

 

The federal agency that administers compliance with this law concerning this creditor is FDIC Consumer Response Center, 1100 Walnut Street, Box #11, Kansas City, Missouri 64106.

 

 

AUTHORIZED SIGNATURE(S)

Leave this empty:

Signature arrow sign here


Signature Certificate
Document name: Allstate TPP Loan Application
lock iconUnique Document ID: 37626c71de4e9f6d9e7ec1d127256eb92e0ce23d
Timestamp Audit
September 11, 2019 5:27 pm CDTAllstate TPP Loan Application Uploaded by Derek Aude - [email protected] IP 174.74.15.20