CBED Loan Interest Form
Company Name
Person acting on behalf of this business
Title
(e.g. CEO, President)
First Name
Last Name
Company Contact Information
Address
Street Address
City
State / Province / Region
Please select...
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
ZIP / Postal Code
Country
Company Phone
Phone Number Format: xxx-xxx-xxxx
Company Email
Company Fax (if any)
Website (if any)
The Company Name listed above is a business and is registered to do business in the State of Hawaii and is in good standing?
Yes
No
The Company Name listed above is current on all County, State, and Federal Tax Filings and Tax Payments?
Yes
No
Do you have financial statements (income statement and balance sheet) for two most recent fiscal years?
Yes
No
Business Information
Date Established
Is business a for-profit business?
Yes
No
Type of Entity
Sole Proprietorship
Partnership / LLP
Limited Liability Company
C-Corporation
Joint Venture
S-Corporation
Type of Business
Manufacturer
Wholesaler
Agricultural
Retail
Other
Other Type of Business
Please describe your business
Annual Revenue
$
Number of Employees
How did you hear about CBED?
Advertisement
Business Referral
Email
Press Release
Website
Word of Mouth (Family/Friend)
NAICS Code
Lookup your NAICS code
(must be in a line of business defined as manufacturing having NAICS code beginning with 31, 32, or 33)
Loan Information
What loan amount are you seeking?
$
Have you had one turndown from a commercial lender in the past year?
Yes
No
What is the loan to be used for?
Start-up costs
Working capital
Purchase, construction, or improvement of facilities
Purchase of equipment
Payment of production and marketing expenses including materials, labor, and services
Other
What is the loan to be used for Other
What type of collateral do you have to secure a loan?
Terms and Conditions
I Agree
This form is for informational purposes only. By checking this box, you acknowledge that you have read and agree to allow the Hawaii Department of Business Economic Development and Tourism (DBEDT) to share this information with the Hawaii Department of Agriculture (HDOA) and other Co-lending Partners and the Hawaii Small Business Development Center (SBDC) for providing feedback on whether company is advised to submit full CBED loan application.
Contact Information