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930 South Bell Blvd, Suite 104 Cedar Park, TX 78613 Phone 512-336-7335/Fax 512-336-7336 Attn: Stephen Lahti


Church Name Street Address City Telephone Denominational Affiliation Senior Minister State Fax Age of Church With Church Since




Equipment Cost $ Equipment Description Anticipated Date of Delivery ______ __

Is the equipment for expansion or replacement? Amount of Financing Anticipated


36 48 or 60 months

Proposed Term of Financing:


The following information is for the Church's fiscal year-end of Current YTD As of ______

2 Years Prior Church Membership Avg. Adult Worship Attendance Unrestricted Contributions Total Receipts Total Expenses Annual Mortgage Payments Total Mortgage Balance Total Other Loans


Last Year


Phone Number Name of Bank/Lender Checking/ Saving Mortgage Lease/Loan Reference Lease/Loan Reference Trade Reference Trade Reference Account Number Monthly Payments Current Balance

Insured value of Church Property $

If your application for business credit is denied, you have the right to a written statement of the specific reason for the denial. To obtain the statement, please contact: Affiliated Investment Group, Inc. 930 South Bell Blvd, Suite 104 Cedar Park, TX 78613 within 60 days from the date you are notified of our decision. We will send you a written statement of reason for the denial within 30 days of receiving your request. NOTICE: The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against applicants on the basis of race, color, religion, national origin, sex, marital status, or age (provided the applicant has the capacity to enter into a binding contract); or because all or part of the applicants income derives from any public assistance program under the Consumer Credit Protection Act. The Federal agency that administers compliance with this law concerning this creditor is the FDIC Consumer Response Center, 2345 Grand Boulevard, Suite 100, Kansas City MO 64108.

PLEASE READ BEFORE SIGNING The Church represents and warrants that all credit and financial information submitted to Affiliated Investment Group, Inc. is true and correct and Affiliated Investment Group, Inc. may obtain any information necessary pertaining to this application. The Church agrees to furnish financial statements to Affiliated Investment Group, Inc. upon request.

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