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LITTLE CANADA BUSINESS REVOLVING LOAN FUND (BRLF) PROGRAM <br />LOAN APPLICATION FORM <br />April 2004 <br />1. Personal Information <br />Applicant's Name: <br />Name of Business: <br />Business Address: <br />Home Address: <br />Home Phone #: Business Phone #: <br />Federal I.D. #: Social Security #: <br />Brief Description of Business: <br />Age of Business: years <br />Previous Location of Business: <br />Number of Years at Previous Location: <br />2. Property Information: <br />Property Owner: <br />Address of Owner: <br />Lease: Yes or No Term: Phone #: <br />Business Square Footage: Present Zoning: <br />Zoning Change Necessary: Yes No <br />- 1 7 - <br />