Capital Access Enrollment Form

At A Glance

Brownfields Insurance

Capital Access

Cumulative Report

List of Banks

Participation Agreement

Community Partners Program

Direct Term Loans

Flexible Loan Guaranty Program for lenders, with all loan terms negotiated solely between the participating bank and the borrower

Capital Access Program
BDC Capital
500 EDGEWATER DRIVE SUITE 555
WAKEFIELD, MA 01880
PH: 781.928.1100
FX: 781.928.1101

Joseph O'Garro, Director x 105
Jogarro@bdcnewengland.com

Capital Access
Enrollment Form

Lender Information:

*Name of Lender:
*Reserve Account#:

Loan Officer Information:

*Name:
*Position:
Street:
City, State, Zip:
*Email:
*Phone:
Fax:

Borrower Information:

*Contact:
*Company Name:
*Street:
*City, State, Zip:
*Phone:
Fax:
Annual Sales:
SIC Code:
No. of Current Employees:
Est. of Jobs Created:
Est. of Jobs Retained:
Total of other indebtedness:

Loan Information:

*Lender Loan No:
*Total Loan Amount:
*Covered Loan Amount:
*Borrower's Reserve Pmt:
*Lender's Reserve Pmt:
*Loan Type:	Term Line
*Maturity (Months):
*Interest Rate (APR):
*Date loan funds available:
Date reserve pmt. deposited:

Fill out the following items ONLY IF REFINANCING A PROGRAM LOAN (Note: New covered loan amount less prior amount enrolled must equal covered amount of this loan):

Prior amount of loan enrolled:
Balance at time of refinancing:
New total covered loan amount:

In filing this loan for enrollment, the lender makes the representations and warranties specified for the Lender in Section 2.2 of the Agreement between the Lender and BDC Capital, as agent for the Massachusetts Office of Business Development.

500 Edgewater Drive, Suite 555
Wakefield, MA 01880
Tel: 781-928-1100 | Fax: 781-928-1101