APSAALOOKE NATION REVOLVING LOAN FUND- BUSINESS LOAN PROGRAM

CHECKLIST
CLIENT NAME:
BUSINESS NAME:
Micro Business Loan: $200 to $5,000
1. ______ ANRLF Loan Application
2. ______
Micro Business loan application
3. ______ List of Equity to be held for Collateral (Items owned to be used to secure loan)
4. ______ Equipment/Vehicle/Building/Material Quotes or Invoices

~ ~ OR ~ ~
Small Business Loan: $5,001 to $10,000
5. ______ ANRLF Loan Application
6. ______ List of Equity to be held for Collateral (Items owned to be used to secure loan)
7. ______ Equipment/Vehicle/Building/Material Quotes or Invoices
8. ______ Written Business Plan (Loan Officer can assistance you with this & the financials)
a.______ 1st year Monthly Projected Cash Flow &-Year 2-3 Cash Flow Projections
b. ______ 3-Year Projected Income Statement
c.______ Projected Balance Sheet
Additional Required Documentation
9. ______ Apsaalooke Certificate of Indian Blood or Tribal ID
10. ______ (Recommended) Apsalooke LLC documents ( District and Council Records)
11. ______ Personal Financial Statement (SBA form)
12. ______ Current Annual Credit Report (AnnualCreditReport.com)
13. ______ 3 Years of Personal Income Tax Returns (or letter of explanation)
14. ______ 3 Years of Business Income Tax Returns (if applicable)
Maximum Loan Amount & Terms:
Micro Business Loan =$200 to $5,000 up to Three Years
Regular Business Loan =$5,001 to $10,000 three up to 5 years
Interest Rate: Prime + 3%
Collateral: Loan amounts will not exceed 90% of collateral value
Loan Guarantees: Guarantees will be accepted and encouraged
Ineligible Purposes: Personal loans, refinancing existing loans or debts
Loan Origination Fee: $25.00 will be charged for all loans to cover expenses associated with the loan.
Proceeds: Interest payments will cover administrative costs and go back into the loan fund to relend.
Qualifications: Crow Enrolled Reservation Based Business
If you have any questions or need help, please call (406) 638-3733 (406)679-0109 or email:
Yolanda.GoodVoice@Crow-NSN.gov for the Loan Manager Yolanda GoodVoice.
Mailing Address:
Apsaalooke Nation Revolving Loan Fund
PO Box 970
Crow Agency, MT

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APSAALOOKE NATION REVOLVING LOAN FUND- BUSINESS LOAN PROGRAM

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APSAALOOKE NATION REVOLVING LOAN FUND- BUSINESS LOAN PROGRAM

LOAN APPLICATION
Date

Print Name
Address City, Zip:
Phone:

Email:
Check box if you would like to be included on emailing list

Amount Requested: $________________

What will you use the loan for?
Working Capital (Cash) $
Inventory/Supplies$
Purchase Equipment/Machinery $
Land/Building$
Guarantee/Leverage $
Enrollment Number: 202-U
Veteran:
Yes No
Age Range:Under 18 18 to 24 25 to 34 35 to 44 45 to 54 55 to 64
Employer:
Supervisor Name/Number
Address City, Zip:
Phone:/Fax
Banking Institution:
Address City, Zip:
Income Sources:
Employment
Un-employment
SSI
Your business
TANF/AFDC/GA
Side jobs

65 & up

Not Applicable/No bank/credit union

Phone:/Fax
Food stamps/commodities
Vocational rehabilitation
Contract work
Veterans benefits
Your business
Other (please specify)

Income Range:
Under $5,000
$5,000 to $14,999
$15,000 to $29,999
$30,000 to $49,999
$50,000 to $69,999
$70,000 and above

Education Level
Some High School High School Diploma GED
Some College
Associates Degree Bachelors Degree
Masters Degree
Doctorate
Business Type:
Retail
Hospitality/food Service Agricultural
Automotive
Cultural Arts & Crafts
Computer/Internet
Professional Services
Other (Please specify):
Business Name:
Years in Operation:
Tribal LLC: Yes No
Business Address, City, Zip:
Status of Business
Idea (No Business plan/Not in operation) Start-up (Partial/Complete Biz Plan/Not in operation)
Existing (in operation) Expanding (In operation/Need to Grow)
Other:______________
Status of Business Plan: Need information Started Writing/Not complete
Complete
Current Number of Employees:
Full-Time
Part-Time
Number of Employees after One Year:
Full-Time
Part-Time
Technical Assistance Needed:
Business Plan Marketing Research
Typing
Business Development
Financials
Marketing your business
Managing Your Money
Other (Please Explain)
Contact References

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APSAALOOKE NATION REVOLVING LOAN FUND- BUSINESS LOAN PROGRAM

Print Name:
Address City, Zip:
Phone:
Print Name:
Address City, Zip:
Phone:

Years Known
Email:
Years Known
Email:

LOAN APPLICATION CONT.

APPLICANTS CERTIFICATION
I/We certify that all information in the application and all information furnished in support of this
application are true and complete to the best of my/our knowledge and belief. Verification may be
obtained from any source named, and I/we agree to submit a personal credit check.
______________________________
SIGNATURE

______________________________
SIGNATURE

______________________________
SIGNATURE

___________________
DATE

___________________
DATE

___________________
DATE

Mail Application to:

Yolanda Good Voice
Loan Manager
Apsaalooke Nation Executive
Economic Development Department
Apsaalooke Nation Revolving Loan Fund
P.O. Box 970
Crow Agency, MT 59022

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APSAALOOKE NATION REVOLVING LOAN FUND- BUSINESS LOAN PROGRAM

LOAN APPLICATION CONT.

INFORMATION RELEASE FORM
Please fill out the form completely for verification purposes:

Applicant Name / Other Information

LAST

FIRST:

M.I.

DATE OF BIRTH:

SSN

DRIVERS LICENSE NO.

FULL NAME AS IT APPEARS ON DRIVERS LICENSE:

FORMER NAMES / MAIDEN NAME AND TIME FRAMES

Addresses
CURRENT ADDRESS:

CITY:

STATE:

ZIP:

DATES TO:

PREVIOUS ADDRESS:

CITY:

STATE:

ZIP:

DATES TO:

PREVIOUS ADDRESS:

CITY:

STATE:

ZIP:

DATES TO:

PREVIOUS ADDRESS:

CITY:

STATE:

ZIP:

DATES TO:

PREVIOUS ADDRESS:

CITY:

STATE:

ZIP:

DATES TO:

Signature: _________________________________________ Date:_______________

I hereby authorize the Apsaalooke Nation Economic Development Office and or any of its authorized agents to gather information about
me regarding the following:
All records including criminal, civil, motor vehicle, professional certification, workers compensation as allowed by law, credit or
education. I also release all information (salary data, etc.) from previous employers (including government agencies, military service, etc.)
whether contained in written records or not or any other pertinent information relating to the successful function of my job.
I hereby release ANECO (its client, as well as agents), former employers, and other references from any liability and understand that there
is no invasion of personal privacy. All information will be obtained in connection with an application for a loan. Upon receipt of a
photocopy of this authorization any such person may accept the photocopy with the same authority as the original authorization.
I have the right to request a copy of the report from ANECO (upon proper identification). If approved fro a loan, this authorization shall
remain on file and shall serve as ongoing authorization for procurement of consumer reports as any time during the length of the loan with
ANECO. I also understand that all information is being obtained pursuant to the Fair Credit Reporting Act (FCRA).
Client Name: _____________________________________________

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Ordered By: __________________________________

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APSAALOOKE NATION REVOLVING LOAN FUND- BUSINESS LOAN PROGRAM

MICRO BUSINESS LOAN APPLICATION

Applicant Name:
Business Name:
Business Physical location and address:
Please Describe Your Business:

Describe your Product or service:

Who are your Customers: Age, Location, Income, Gender, Etc.?

Who are your Competitors: Name, Location, Prices compared to yours, etc?

What makes you different than your competitors?

How do you plan to advertise to your customers? How do you know this will work? How
much will it cost and how often?

What items of value have you or will your contribute to your business? Please provide
proof of value if possible (This is your owners contribution to your business)

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APSAALOOKE NATION REVOLVING LOAN FUND- BUSINESS LOAN PROGRAM

MICRO BUSINESS LOAN APPLICATION

Use of Loan Funds Worksheet

The Committee needs to see how you plan to utilize the Loan Funds for your
business. Please complete each area, item and description, Reason for need of
item, Vendor/business you will be purchasing your supplies/ products from, Cost of
each item, Quantity/amount needed of item, total cost (cost times quantity).
Please attach any documents that provide documentation for purchases.
Quantit
Item/ Description
Reason
Vendor
Cost
Total
y
1
2
3
4
5
6
7
8
9
1
0
1
1
1
2
1
3
1
4
1
5
1
6
1
7
1
8

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Rev 10-11-12

APSAALOOKE NATION REVOLVING LOAN FUND- BUSINESS LOAN PROGRAM

1
9
2
0

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APSAALOOKE NATION REVOLVING LOAN FUND- BUSINESS LOAN PROGRAM

MICRO BUSINESS LOAN APPLICATION

Focusing on Costs, please detail your plan for each month of the next year: where will you sell your
items, How much will it cost, When will you advertise and cost, how much sells do you expect to make?
This will help you PROJECT YOUR COSTS over the next year.
Pre-Start-up:

Month 1:

Month 2:

Month 3:

Month 4:

Month 5:

Month 6:

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APSAALOOKE NATION REVOLVING LOAN FUND- BUSINESS LOAN PROGRAM

Month 7:

Month 8:

Month 9:

Month 10:

Month 11:

Month 12:

Please continue to next page---------------

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Pre Startup
CASH FLOW Year One
Estimate

Month
1

Month
2

Month
3

Month
4

Month
5

Month
6

Month
7

Month
8

Month
9

Month
10

Month
11

Month
12

Estimate

Estimate

Estimate

Estimate

Estimate

Estimate

Estimate

Estimate

Estimate

Estimate

Estimate

Estimate

Cash on Hand
(cash position from prev month)
Cash Sales A
Cash Sales B
Cash Sales C
Collections from Credit Account
Loan or Cash Injection
Cash Receipts
(total Cash received-not cash on
hand)
Total Cash Available
(cash on hand + cash receipts)
Cash Paid Out (Biz Bills)
Cost of Goods Sold
Gross Wages
Payroll Expense
Supplies (Office & Operating)
Repairs & Maintenance
Advertising
Car, Delivery, and Travel
Accounting and Legal
Rent
Telephone
Utilities
Insurance
Interest - Bank
Interest - Gap
Other Expenses
Miscellaneous
Subtotal (biz bills)
Loan Principal Payment - Bank
Loan Principal Payment - Gap
Capital Purchases
Other Start-up Costs
Income Tax Reserve
Owners Withdrawal
Total Cash Paid Out(biz bills + blue)
Cash Position
(Cash Avail -Total cash out)

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Year 1
TOTAL
add
across

Page 12 of 16

HOW TO GET YOUR FREE ANNUAL CREDIT REPORT

Posted Feb 28 2011 by Credit.org in Credit and Debt
In todays tutorial we will demonstrate how to obtain
your free annual credit report from
AnnualCreditReport.com, the only official site
that allows consumers to request a free credit file
disclosure, commonly called a credit report, once
every 12 months from each of the nationwide
consumer credit reporting companies: Equifax,
Experian and TransUnion. Lets get started!

Step 1
In your internet browser, log in to http://www.annualcreditreport.com. When you arrive, make sure your
connection to the website is secured by clicking on the Verisign Secured icon on the bottom right.
Example of verification of secure connection: ------

Step 2
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Once you have verified the connection is secure, select your state and click on Request Report.

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Step 3
Fill in the form with your personal information. Verify your information before proceeding, and when you are
ready click on Continue.

Step 4
Select which credit reporting company you want to request a report from. It is recommend to request a report
from all 3 companies. Click Next when you are ready to proceed.

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Step 5
A prompt will appear explaining that you may return to the original website by clicking on the button in the blue
circle. Click Next to continue.

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Step 6
You will be directed to your first report, in this case
Experian. The company will ask you to verify your
personal information to safeguard your report.
Continue with the process until you are presented with
your report. Make sure you either save a copy of the
report on your computer or print it out for your records.
Note: Throughout the process you may be presented
with the opportunity to view your credit score or FICO
score. This is not part of the free annual credit report
process and additional fees are required to access these scores. Remember, it is not necessary to request your
score in order to view your credit report.
When you have viewed your report from Experian,
click on Return to AnnualCreditReport.com on the top
navigation bar to continue with your credit report
request from Equifax and Transunion.

Step 7
Equifax will ask you to verify your personal information to safeguard your report. Continue with the process
until you are presented with your report. Make sure you either save a copy of the report on your computer or
print it out for your records.
Note: Throughout the process you may be presented with the opportunity to view your credit score or FICO
score. This is not part of the free annual credit report process and additional fees are required to access these
scores. Remember, it is not necessary to request your score in order to view your credit report.
When you have viewed your report from Equifax, click on Return to AnnualCreditReport.com on the top
navigation bar to continue with your credit report request from Transunion.

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Step 8
Transunion will ask you to verify your personal information
to safeguard your report. Continue with the process until
you are presented with your report. Make sure you either
save a copy of the report on your computer or print it out
for your records.
Note: Throughout the process you may be presented with
the opportunity to view your credit score or FICO score.
This is not part of the free annual credit report process and
additional fees are required to access these scores.
Remember, it is not necessary to request your score in order
to view your credit report.
When you have viewed your report from Transunion, you
have completed the process of obtaining your free annual
credit report. It is advised you close your internet browser
at this time.

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