Borrowing Entity

Legal Entity Name *

Entity Type *

State of Formation *

Business Address *

Business Phone *

Years in Business *

Business Email *

Please provide a brief description of your business / industry

Loan Request

Loan Type *

Loan Amount Requested *

$

Requested Loan Term (in Months)*

Loan Purpose *

Describe loan purpose in detail

Collateral type (select all that apply)

Personal Guarantors

Personal Financial Statement required for each guarantor.
A Personal Financial Statement must be completed by every individual providing a personal guaranty in connection with this loan request — typically each beneficial owner with greater than 20% ownership interest. Please indicate how many guarantors will be providing personal guaranties below.

Number of guarantors providing personal guaranties *

Personal Financial Statement

This form must be completed by each individual providing a personal guaranty in connection with this loan request (e.g., provide for each beneficial owner with greater than 20% ownership interest). All amounts should be stated in even dollars as of the date of this application.

Guarantor 1

Personal Financial Statement 1 of 1

Guarantor information

Full Legal Name

—

Ownership % *

Date of Birth *

Home Address *

Home Phone *

Employer / Company Name *

Position / Profession *

Employer Address *

Employer Phone *

Years with Employer *

Income Taxes Settled Through *

Disclosures

Partner, officer, or owner in any other venture? *

No Yes

Are any assets pledged? *

No Yes

If yes, detail in Schedule A

Have you ever been a defendant in any lawsuits or legal proceedings? *

No Yes

Have you ever filed for bankruptcy or been involved in any insolvency proceedings? *

No Yes

Assets (in even dollars)

Cash on hand & in banks (Schedule A)

$

Checking, savings, and money market accounts

U.S. government securities (Schedule B)

$

Treasury bills, notes, and bonds

Listed securities (Schedule B)

$

Publicly traded stocks and bonds — use market value

Unlisted securities (Schedule B)

$

Private company equity — attach financial statements

Other equity interests (Schedule B)

$

LLC membership interests and partnership interests

Accounts & notes receivable

$

Amounts owed to you by others

Real estate owned (Schedule C)

$

Current market value of all owned real property

Mortgages & land contracts receivable (Schedule D)

$

Amounts owed on seller-financed real estate

Cash value — life insurance (Schedule E)

$

Accumulated cash surrender value only

Other assets — itemize below

$

Itemization of other assets

Liabilities (in even dollars)

Notes payable — this bank (Schedule A)

$

Notes payable — other institutions (Schedule A)

$

Notes payable — relatives

$

Notes payable — others

$

Accounts & bills due

$

Credit cards, unpaid invoices, and trade payables

Unpaid taxes

$

Federal, state, and local — include amounts in arrears

Real estate mortgages payable (Schedule C or D)

$

Land contracts payable (Schedule C or D)

$

Life insurance loans (Schedule E)

$

Guaranteed payments to third parties

$

e.g., payments to prior owners and earnout obligations

Other liabilities — itemize below

$

Itemization of other liabilities

Sources of Income (annual, in even dollars)

Salary

$

Bonus & commissions

$

Dividends

$

Real estate income (net)

$

Net rental income after expenses

Alimony / child support received *

$

* Need not be disclosed unless relied upon for credit

Other income — itemize

$

Itemization of other income

Contingent Liabilities (in even dollars)

As endorser, co-maker, or guarantor

$

Loans you have co-signed or guaranteed for others

On leases

$

Remaining obligations on guaranteed leases

Legal claims against you

$

Estimated exposure from pending lawsuits

Provision for federal income taxes

$

Estimated taxes owed and not yet paid

Other special debt

$

Recourse obligations, repurchase liabilities, etc.

Supporting Documents — Personal Financial Statement

Please upload documents that support the financial information provided above. For unlisted securities or partnership interests, attach current financial statements to support the basis for valuation.

Accepted: PDF, JPG, PNG, XLSX, DOCX

Click to Upload or Drag and Drop

Tax returns, bank statements, brokerage statements, unlisted security financials, etc.

Schedules A–E

Complete the applicable schedules below for each guarantor. Use the navigator to step through each guarantor's schedules.

Guarantor 1

Schedules A–E — 1 of 1

Schedule A — Banks, Brokers, Savings & Loan Associations, Finance Companies, and Credit Unions

Name of Institution	Name on Account	Account Type	Balance on Deposit ($)	High Credit ($)	Amount Owing ($)	Monthly Payment ($)	Secured By What Assets

Schedule B — U.S. Governments, Stocks (Listed & Unlisted), Bonds, and Partnership Interests

Agency / Company / Partnership Name	Investment Type / Equity Classification	Shares / Face value / % Ownership	Basis of Valuation	In Name Of	Market Value ($)	Pledged? (Yes / No)

For unlisted securities or partnership interests, attach current financial statements to support basis for valuation.

Schedule C — Real Estate Owned (and Related Debt)

Property Description / Address	Title in Name Of	Date Acquired	Cost + Improvements ($)	Present Market Value ($)	Mortgage / LC Balance Owing ($)	Monthly Payment ($)	Mortgage Holder

Schedule D — Real Estate: Mortgages & Land Contracts Receivable (and Related Debt)

Property Description / Address	Title in Name Of	Date Acquired	Balance Receivable ($)	Monthly Payment ($)	Mortgage / LC Balance Owing ($)	Monthly Payment on Payable ($)	Holder

Schedule E — Life Insurance Carried

Name of Insurance Company	Policy Type	Face Amount ($)	Cash Surrender Value ($)	Loans Against Policy ($)	Beneficiary

Supporting Documents — Schedules A–E

Please upload documents that support the schedule information above for this guarantor.

Accepted: PDF, JPG, PNG, XLSX, DOCX

Click to Upload or Drag and Drop

Mortgage statements, brokerage confirmations, property valuations, life insurance policy summaries, etc.

Debt Schedule — All Outstanding Loans

List every outstanding loan for the borrowing entity. Include real estate, equipment, term loans, lines of credit, SBA loans, Merchant Cash Advances, and any other debt obligations.

Name of Lender	Origination Date	Maturity Date	Loan Category	Interest Rate (%)	APR (%)	Collateral Securing Loan	Original Amount ($)	Outstanding Balance ($)	Monthly Payment ($)	Personal Guarantees?	Name(s) of Guarantor(s)	Prepayment Penalty?	Penalty Amount ($)

Supporting Documents — Debt Schedule

Please upload loan statements, promissory notes, or other documents that support the debt schedule above.

Accepted: PDF, JPG, PNG, XLSX, DOCX

Click to Upload or Drag and Drop

Loan statements, promissory notes, term sheets, payoff letters, etc.

Certification

I hereby certify that the information provided in this application is true, accurate, and complete to the best of my knowledge and belief. I authorize WSC Finance LLC, its affiliates, successors, assigns, and their respective agents to verify any information provided, including obtaining commercial and/or consumer credit reports, background checks, and other relevant financial, business, or personal information, at the time of application and periodically thereafter in connection with the underwriting, extension, and administration of credit. I acknowledge that any material misrepresentation or omission may result in denial, termination, or acceleration of credit.

Printed Full Legal Name *

Title / Capacity *

Date Signed *

Date of Birth *

Signature * — draw in the box below

Draw your signature above using your mouse or touchscreen

I have read, understand, and agree to the certification statement above.

Application Submitted

Your loan application has been received by Woodland South Capital and logged in our system. Your relationship manager will follow up shortly.

Reference — WSC-XXXXXX