Information Gathering Form

Please fill out the information below to be considered for a 5 year Flood Relief loan with Frontier Bank. Once we receive the completed form, a Frontier Bank lender will be in touch within 1-2 business days.

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* Preferred Frontier Bank Branch:

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* How did you hear about the Frontier Bank Flood Relief Loan program?

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* Amount Requesting (Maximum of $20,000):

Business Information:

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* Legal Business Name:

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* DBA, if applicable:

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* Nature of Business:

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* Year Business was established:

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* Current owner since:

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* Business Location:

Business Owner(s) Information:

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* Business Owner #1:

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* Email Address:

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* Phone Number:

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* Business Owner #2:

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* Email Address:

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* Phone Number:

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* Business Owner #3:

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* Email Address:

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* Phone Number:

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* Business Owner #4:

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* Email Address:

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* Phone Number:

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* Business Owner #5:

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* Email Address:

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* Phone Number:

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* Business Owner #6:

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* Email Address:

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* Phone Number:

Underwriting Standards Apply.

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