All * fields are required

Type of Organization/Ownership:
Non-Profit Corporation or Ministry Corporation, for profit
DBA / Sole Proprietorship Partnership
Unincorporated Non-Business Other
Number of Employees/Staff for the Last Three Years:
2014 2015 YTD
Church Attendance for the Last Three Years (if applicable):
2014 2015 YTD
Sunday School
Sunday Morning
Sunday Evening
Saturday Evening
School Enrollment (Monday to Friday) for the Last Three Years (if applicable):
2014 2015 YTD
High School
Income Statement Summary:
2014 2015 YTD
Annual Income for all sources
Annual Expenses
Net gain or loss
Please attach statement explaining any substantial net loss. A statement is also required if the net gain is not sufficient to cover the annual payments on the new loan.
Balance Sheet Summary for Period Ending: December 31,
2014 2015 YTD
Current Assets (cash, negotiable securities)
Real Property (market value)
Other assets
Total Assets
Current Liabilities (due in one year or less)
Long Term Liabilities
Total Liabilities
Net Worth (excess of assets over liabilities)
Schedule of Payments Summary:
Please attach the accompanying "Schedule of Present Loans" form itemizing each loan and corresponding payment amount. Please include mortgage payments, rent, payment, and other contractual monthly obligations.
Total Monthly Obligations
Please attach financial statements supporting the above numbers.