UNIVERSAL CONNECTION Inc.
646-373-3446
RELIGIOUS ORGANIZATION LOAN QUESTIONNAIRE Page 1 of 3
General Information (if more room is required, please feel free to attach an additional sheet.)
Name of Organization:_________________________________________________________________________
Legal Structure (Corporation, Partnership, Other):_________________________________________
Is the organization incorporated under the laws of the state where located:______________________
Address:______________________________________________________________________________
Phone Number:________________________________________________________________________
Primary Contact:______________________________________________________________________
Tax ID Number:_______________________________________________________________________
Inception date of organization:___________________________________________________________
Number of worship services held per week:_________________________________________________
Seating capacity of current facility:________________________________________________________
Name of head clergyman:_______________________________
Length of time with organization:_________________
Full or part time:_______________________________
Age of head clergyman:__________________________
Name of other Staff clergyman:__________________________________________________________
Member of denomination body, if any:_____________________________________________________
How is body structured:_________________________________________________________________
Contributions to body annually, if any:_____________________________________________________
What committee is in charge of financial related affairs:______________________________________
What committee is in charge of other decisions:_____________________________________________
What is length of service for persons involved in decision-making functions:_____ _______________
What is/was the start date:_______________________________________________________________
When were payments against pledges to start ?_____________________________________________
What is/was the length of the campaign?__________________________________________________
How much is pledged to date ?___________________________________________________________
How much has been collected to date ?____________________________________________________
If any pledges are over $25,000, please list a mounts:_________________________________________
Did you/will you use a professional fundraisers?
If yes, which ones ?_____________________________________________________________________
Is the following insurance coverage in place ?
Fire_______ Extended Coverage________ Vandalism_________ Malicious Mischief______________
Will this coverage remain in force ?_______________________________________________________
UNIVERSAL CONNECTION Inc.
646-373-3446
RELIGIOUS ORGANIZATION LOAN QUESTIONNAIRE Page 2 of 3
Have all necessary local permits been received ?____________________________________________
Does the organization understand that in the mortgage will be a clause that in the event the
organization ceases to cooperate with the local association in which the organization is located or
affiliated, or if the property should be sold, leased or otherwise disposed of, the remaining
indebtedness will become due and payable immediately?_____________________________________
Additional Information Requested
1.) Resume from head clergyman
2.) Brief history of organization
3.) Last five years’ fiscal year-end statements
4.) Current interim financial statement
5.) Current budget
6.) Operating projections for the next three years
Financial Information (Please attach actual financial statements)
Year (Please indicate fiscal year end by month and year) _____ _____ _____ _____
Operating Budget _____ _____ _____ _____
Actual Operating Income _____ _____ _____ _____
Membership _____ _____ _____ _____
Giving Units _____ _____ _____ _____
(Family units or Single, Employed Adults)
Average Worship Attendance _____ _____ _____ _____
Average Sunday school Attendance _____ _____ _____ _____
Breakdown of Current Membership:
Under 18: ____________________
18-25 ________________________
25-35 ________________________
35-45 ________________________
45-55 ________________________
55-65 ________________________
65+ _________________________
When was the membership list last purged? ________________________________________________
List the individual amounts given by your top ten donors:
1 2 3 4 5 6 7 8 9 10
Who writes checks for the organization ? __________________________________________________
Signs checks ?_________________________________________________________________________
Reconciles Bank Statements?____________________________________________________________
What are your average total depository balances?___________________________________________
How many bank accounts do you have?____________________________________________________
Who do you bank with?_________________________________________________________________
UNIVERSAL CONNECTION Inc.
646-373-3446
RELIGIOUS ORGANIZATION LOAN QUESTIONNAIRE Page 3 of 3
Please provide a summary of any borrowings or capital additions completed in the last 10 years:
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Property Information
How many acres do you currently own ?___________________________________________________
Square footage of current facility:_________________________________________________________
Date facility acquired and cost:___________________________________________________________
List a description, year completed and cost of any improvements:______________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
How far to the nearest associated church?__________________________________________________
Appraised value of property and improvements, if known:____________________________________
a) Date of appraisal:____________________________________________________________________
b) Name of appraiser:___________________________________________________________________
Date and name of surveyor on latest survey:________________________________________________
Do you have owner’s title insurance?______________________________________________________
a) Title company:________________________________________________________________
b) Policy #:_____________________________________________________________________
Project Information (Please attach all pertinent budgets, drawings, etc.)
Please describe the current project (square footage, number of buildings, etc.)
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Who is the architect ?___________________________________________________________________
Who is the contractor:___________________________________________ Bonded?________________
Construction___________________________________________________________________________
Softcosts______________________________________________________________________________
Furniture fixtures_______________________________________________________________________
Contingency___________________________________________________________________________
Land_________________________________________________________________________________
Interest during construction______________________________________________________________
What is the amount of the loan request ?___________________________________________________
What is the estimated length of construction ?______________________________________________
How much cash is available today ?_______________________________________________________
Are you/will you be involved in a special fund raising campaign for the project ?_________________
|
|