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Fax: 281.550.9391

Financial Analysis Worksheet

Please print out and complete the following Financial Analysis Form. With the information you provide, Dickerson & Associates will determine the feasibility of your Church Financing Project. Upon completion of this form, be sure to FAX copies of all required documentation listed below to our Business Office at (281) 550-9391. If you have any further questions, please contact Dickerson & Associates.

OFFICIAL CHURCH INFORMATION
Legal Name Of The Church:
Church Address:
Phone Number:			FAX Number:
City:			State:	Zip Code:
E-Mail Address:
Website:
Denomination Affiliation:
Date Of Organization:			Date Of Incorporation:
Federal Tax ID Number:
LOAN PURPOSES
Total Amount of Loan Requested:
Construction Cost:
Property Purchase Cost:
Refinance Cost:
Is there any type of financing unacceptable to your Church? (For Example: Private Investors, Insurance Companies, Bonds, Notes, Banks, Joint Partnerships)			No Yes
If yes, which type is unacceptable?
PASTOR / MINISTER INFORMATION
Pastor / Minister:			Title:
Home Phone Number:
CONTACT PERSON INFORMATION
Contact Person:			Title:
Home Phone Number:			Business Phone Number:
Mobile Phone Number:			FAX Number:
E-Mail Address:			Best Time And Place To Contact:
CPA / ACCOUNTANT INFORMATION
CPA / Accountant:
Phone Number:			FAX Number:
Address:
City:			State:	Zip Code:
Best Time And Place To Contact:
FINANCIAL HISTORY / PROFILE
Has the Church been involved in any litigation within the past ten years?			No Yes
Is the Church aware of any pending or future litigation?			No Yes
Has the Church ever defaulted on a previous bond issue, loan, or mortgage?			No Yes
Are there any contracts, if terminated, would affect the Church s income?			No Yes
Does the Pastor or any other staff member in a leadership position intend leaving the Church before the funding of this loan?			No Yes
Is the Church currently or in the past in default of any financial liability?			No Yes
Has The Church ever issued Bonds?			No Yes
Has The Church ever issued personal notes?			No Yes
Approximate Value of Existing Properties:			Amount of Current Debt to be Paid Off:
Purchase Price of New Property:			Approximate Value of New Property:
OUTSTANDING LOAN DETAIL (Land & Buildings Only)
	Debt 1	Debt 2	Debt 3	Debt 4
Present Balance:
Monthly Payment:
Original Loan Amount:
Date Started:
Length Of Debt:
Rate Of Interest:
Item Purchased:
CHURCH ATTENDANCE INFORMATION
Year	Sunday AM Worship	Members	Members Under Age 18	Number Of Families
2002
2003
2004
2005*
Church Fiscal Year Begins: January February March April May June July August September October November December			*Number Of Months To Date: 0 1 2 3 4 5 6 7 8 9 10 11 12
PLEASE PROVIDE THE FOLLOWING IMPORTANT INFORMATION *The Financial Analysis Cannot Be Completed Unless the Following Required Documentation Is Provided FAX (281) 550-9391 1. Financial Statements for the past three years plus current year period. 2. A brief history of The Church. 3. A brief resume or narrative history of the Senior Pastor/Minister. The Church certifies that it understands that Loan Underwriting approval is subject to a due diligence investigation by Dickerson & Associates and / or its Lending Sources and cannot be completed until all required documentation has been submitted and verified. IF the Church is approved for Loan Underwriting, the following will be required: 1. Current appraisal of all Real Estate used as collateral provided by a certified commercial appraiser. 2. CPA Audited, Reviewed, or Compiled Financial Statements per GAAP for three years. By submitting this form, I certify that all information contained herein is true and accurate to the best of my knowledge.
Prepared By:			Date:

 

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