District Capitalized Revolving Fund: Micro-Line of Credit Application

Eligibility Form and Loan Application for the District Capitalized Revolving Fund in partnership with DSLBD

Eligibility Form

Do you operate a business that is any of the following:

a franchise that is not independently owned and operated;
licensed with DLCP under residential rental housing categories;
seller of selling illegal goods or services; and/or
seller of cannabis products or services (THC)?

Does your business have fewer than twenty‐five (25) full‐time employees?

Have your business or its owners been subject to suspension and/or termination of a grant agreement from any Government of the District grant program within the past five (5) years?

Have you completed DC’s Department of Small and Local Business Development’s Equitable Access to Capital Survey? If not, please complete the survey at:

EAC FORM LINK

Does your business face barriers accessing affordable lines of credit and other financing with traditional funders? If yes, please describe specifically and briefly. If no, enter “N/A”

If you are eligible for the District Capitalized Micro-Line of Credit, please continue by filling out the below loan application.

Micro-Line of Credit Application

Personal Information

First Name *

Middle Name *

Last Name *

Home Address (street) *

City *

Zip code *

Cell Phone # *

Home Phone # (if any)

Email *

Social Security Number *

ITIN (if applicable) *

In what Ward/County do you live? *

Birth Date *

Gender *

Family Size

# of Adults *

# of Children *

Employment Status

Name of Employer

Your Position

Employer's Address

Phone Number

Annual Income (outside of business income) *

Household Income (do not include business income) *

Business Information

Name of Business *

What type of business are you in? (e.g. transportation, daycare, retail, food, clothing, consultant etc) *

Years you have been in business *

Business Address *

Ward/County of business *

Business Email *

Business Phone Number *

Business Website (if any)

Facebook (business) (if any)

Instagram (business) (if any)

LinkedIn (if any)

Type of Business:

Employee Identification Number, EIN (if any)

UEI (Unique Entity Identifier, if any)

Dun & Bradstreet D-U-N-S Number (if any)

DC Corporate File Number: (can be found at https://corponline.dlcp.dc.gov)

Active DC Corporate File Number *

DC Business License Number: (can be found at https://scout.dcra.dc.gov)

Active DC Business License Number *

Business Information Continued

Average time spent on business (hours per week) *

Types of Products provided *

Types of Services provided *

Annual Gross Business sales last year *

Net Profit last year *

# of Current full-time employees (self included) *

# of Current part-time employees *

# of current consultants / contractors *

Detailed Loan Information

Requested Line of Credit Amount *

How do you plan on using your Line of Credit? *

Credit Score

Current Credit Score *

Bank information for my monthly ACH loan repayment:

Bank Name *

Routing Number *

Account Number *

Monthly loan payment you're comfortable paying: *

Upload Documents

This form offers an upload feature for both a file and for an image with a maximum size of 3 megabytes.

Acceptable file types are .pdf, .docx, .doc, .odt, .rtf, .txt.

Acceptable image types are: .png, .jpg, .jpeg.

Personal Bank Statements

Please upload your bank statements from the last three months, verifying stated income. (If income does not show in your bank statement, please also submit a copy of your pay stub.)

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Business Income Documents

Please upload your bank statements from the last three months, and other documents showing business income.

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Credit Score

Please upload a copy of your credit score.

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Credit Report

Please upload your credit report. You can access a copy of your free credit report at www.annualcreditreport.com.

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Please upload a copy of void business check or a similar document that includes name, routing and account number. (If business account is not available, you can submit personal checking info.) If approved, this account will be used for loan disbursement.

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Tax Returns

Please upload your personal tax returns from the last two years.

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Please upload your Business tax returns from the last two years.

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Please upload a copy of your Drivers License/ID

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Copy of Social Security Card

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If country of origin is not the USA, please upload one or more of the following: passport, green card, work permit, visa, naturalization papers, ITIN, or other

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Please upload proof of active DC Business License (can be found at https://scout.dcra.dc.gov)

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Please upload proof of active business status (can be found at https://corponline.dlcp.dc.gov)

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Socio-Economic Information

Life Asset values equality and does not discriminate on the basis of race, color, creed, sex, age, national origin, handicap, sexual orientation, or any other classification protected by applicable state or federal discrimination laws.

Country of Origin *

Years Living in the U.S. *

Primary Language *

Agreements

I am ready to submit my loan application. I certify that, to the best of my knowledge and belief, all information contained in this loan application and in the accompanying statements and documents is true, complete, and correct. I agree to notify Life Asset immediately of any material changes in this information. I understand that Life Asset may request additional information. Due to the individual circumstances for each loan, your loan officer might ask for further details to provide you with the best possible service. I authorize Life Asset to check my credit history, including verification of the information on this loan application.

I agree to the above statements

I agree to receive important notifications, updates, and information regarding my account or services via email and text messages. I understand that message and data rates may apply for text messages and that I may opt out of receiving these communications at any time by following the instructions provided in the communications.

I agree

Further Information

How did you hear about Life Asset's Micro-loan Program *

Who referred you to Life Asset? (if any)

Is there anything else you’d like to share about your experience, the program, or your work with Life Asset’s employees and volunteers?

For Life Asset Use Only (below is to be filled out by Life Asset):

Memo

Thank You, we will be in touch!