CHURCH INFORMATION WORKSHEET Page 1Church NameAddressCityStateOption 1Option 2Option 3ZipcodePhoneFaxEmailWebsiteTax I.D NumberReferral Contact NameSr. Pastor NameTitleFirstnameLastnameCell Phone NumberEvening Phone NumberPage 2Attendance And ContributionsAVERAGE WEEKLY SUNDAY ATTENDANCE (ADULTS)2015201620172018Weekly Average Tithes, Offerings & Other Donations2015201620172018Page 3Current Loan InformationLender NameCurrent Loan BalanceTerms and Rate of Current LoanIs The Church Current On Loan Repayment?YesNoIf No, Please ExplainCurrent Property DebtApproximate Appraisal ValueCurrent Monthly PaymentBalloon DateRadio GroupOwnLease/RentOption 3CommentsNew Loan InformationPurpose For LoanPurchaseRefinanceRenovationCondtructionOtherChurch AfiliationGive a Detailed Description Of Your Project and Funding RequestEstimated Amount Of RequestDown Payment Amount - Church ContributionPage 4Submission SectionRepresentative Contact InformationForm Completed ByTitleFirstnameMiddlenameLastnamePhoneEmailI/We hereby authorize the release to Nexus Financial Group, and/or any affiliates of any and all information that they may require for the purpose of a credit transaction. I/We further authorize Nexus Financial Group and/or any affiliates to release such information to any entity they deem necessary for any purpose related to our credit transaction with them. I/We certify that the enclosed information (plus any attachments or exhibits) is valid and correct to the best of my/our knowledge.*AgreeSend Error occured. Please confirm your data and submit again:
