Small Business Loan Application

** INCOMPLETE APPLICATION **

This application has not been submitted.
Required fields are denoted as follows: Field Title
Important Information About Procedures for Opening a New Account. To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account. What this means for you: When you open an account, we will ask you for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver’s license or other identifying documents.
Application Taken Date:
An individual on this application is an employee of Emprise Bank?
If you need assistance filling out this application please call our Customer Service Center at (855) 383-4301 or (316) 383-4301.
Credit E-Sign
Credit Card Application Requirements

Before proceeding you must confirm that you have read and agree to the terms of the Electronic Signature Act Disclosure available at the link below. If you cannot view the disclosure below, click on the Adobe Reader icon to download the latest version.


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E-SIGN Act Disclosure

Before filling out the Credit Card Application, please review the following Credit Card Terms and Conditions.

Borrower Information
Borrower 001
If no trade name is used, enter legal name.
(mm/dd/yyyy)
Credit Request
Product 001
Voluntary Government Monitoring Information
COMPLETE THIS SECTION ONLY IF THE PURPOSE OF THE REQUESTED LOAN IS FOR THE PURCHASE, REFINANCE
OR HOME IMPROVEMENT OF A DWELLING AND SECURED BY A DWELLING.
(Not Applicable to Home Equity Lines)
The following information is requested by the Federal Government for certain types of loans related to a dwelling in order to monitor the lender's compliance with equal credit opportunity, fair housing and home mortgage disclosure laws. You are not required to furnish this information, but are encouraged to do so. The law provides that a lender may discriminate neither on the basis of this information, nor on whether you choose to furnish it. If you furnish the information, please provide both ethnicity and race. For race, you may check more than one designation. If you do not furnish ethnicity, race, or sex, under Federal regulations, this lender is required to note the information on the basis of visual observation or surnames. If you do not wish to furnish the information, please choose the selection below.
Borrower
Co-Applicant ( If applicable )
Guarantor Information

If an applicant was entered as a borrower, do not enter that applicant again in this section as a guarantor.

Guarantor 001
Additional Information