Coronavirus Business Interruption Loan Scheme (CBILS) application form

Declaration and Eligibility - Step 1 of 6

I can confirm I have read and agree to the above declaration. *

Please tick this box.

Please complete the answers to the following 4 questions to check your eligibility for the CBILS Scheme

Please note, if you answer no to any of the questions, you may not qualify for the CBILS scheme. If this is the case, please complete the form and a consultant will contact you to discuss your options.

CBILS are only available for businesses affected by COVID-19. Has your business been impacted by COVID-19? *

Does your business generate more than 50% of their turnover from their trading activity? *

Will the funding required be used to support business activity within the UK? *

Is the purpose of this loan for working capital or expansion/growth? *

CBILS Eligibility

To be eligible for a CBILS loan through the scheme you must not have applied for or received a loan under the Bounce Back Loan Scheme (BBLS), the Coronavirus Large Business Interruption Loan Scheme (CLBILS) or the Bank of England's COVID Corporate Financing Facility (CCFF).

Has your client previously applied for or received a BBLS, CLBILS or CCFF loan? *

Will this loan be used to buy land or property with the sole intent of renting or selling it? *

Will this loan be used to significantly change the business’ main trading activity? (e.g. retail business to manufacturing business) *

Will this loan be used to settle personal debt? *

Will this loan be used to fund an opportunity outside the UK? *

Will this loan be used by a company besides the one selected? *

Name *

First

Last

Are you a director of the business applying for the loan? *

Primary Contact Number *

Email Address *

Business Name *

Company Type (please select one) *

Limited company
Limited Liability Partnership
Partnership (4 or more partners)
Partnership (Less than 4 partners)
Sole trader

Does the Business have an annual turnover of less than £400,000 *

How long has the business been trading *

How did you find out about the Digital Application Portal (DAP)? *

Business Advisor
Twitter
Linked In
Search Engine
Referral from a friend or colleague
Other

Name of the Introducer: *

Name of Introducer's Company: *

Which Search Engine did you find us on? *

Google
Yahoo
Bing
Other

If other, which Search Engine did you find us on? *

If other, how did you find out about the Digital Application Portal (DAP)? *

Loan Amount (£) *

Loan Term (months) *

Primary Loan Purpose *

Working capital
Expansion / growth

What does the business do and what is the loan for? *

Please provide a link to the company website if available. 750 characters max.

Coronavirus Impact Statement *

Please provide a description of how the current restrictions have impacted on your business and what actions you have taken so far to secure the future of your business. 750 characters max.

Date Business Commenced Trading *

Last Year's Turnover (£) *

Are any of the business owners a homeowner? *

Company Number (if Limited)

Business Registered Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Is your Trading Address different to your Business Registered Address? *

Trading Address (if different) *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Number of full-time employees (excl. directors) *

Business Sector *

Does the business bank account have an overdraft? *

Overdraft Limit *

Current Usage *

Has the business taken on more than £25,000 new debt in the last year? *

Total amount of debt (£25,000 or more) *

Shareholders or proprietors (at least 20% shareholding) of the business - should have no significant adverse credit.

How many shareholders or proprietors (at least 20% shareholding) of the business are there? They should have no significant adverse credit. *

Owner 1

Name *

First

Last

Date of Birth *//

Personal Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Date moved in to Personal Address *//

Previous Personal Address (if you have been at the current address for less than 3 years)

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Date moved in to Previous Personal Address (if required) //

Date moved out of Previous Personal Address (if required) //

Owner 2

Name *

First

Last

Date of Birth *//

Personal Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Date moved in to Personal Address *//

Previous Personal Address (if you have been at the current address for less than 3 years)

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Date moved in to Previous Personal Address (if required) //

Date moved out of Previous Personal Address (if required) //

Owner 3

Name *

First

Last

Date of Birth *//

Personal Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Date moved in to Personal Address *//

Previous Personal Address (if you have been at the current address for less than 3 years)

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Date moved in to Previous Personal Address (if required) //

Date moved out of Previous Personal Address (if required) //

Owner 4

Name *

First

Last

Date of Birth *//

Personal Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Date moved in to Personal Address *//

Previous Personal Address (if you have been at the current address for less than 3 years)

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Date moved in to Previous Personal Address (if required) //

Date moved out of Previous Personal Address (if required)//

Owner 5

Name *

First

Last

Date of Birth *//

Personal Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Date moved in to Personal Address *//

Previous Personal Address (if you have been at the current address for less than 3 years)

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Date moved in to Previous Personal Address (if required)//

Date moved out of Previous Personal Address (if required) //

Certified Accounts - File Upload *

Click or drag files to this area to upload. You can upload up to 2 files.

Please upload the latest set of filed accounts (full set and not the modified version please). If the certified accounts are more than 9 months old, please also provide management accounts for the last full trading year.

Management Accounts - File Upload

Click or drag a file to this area to upload.

Please upload the latest set of management accounts (P & L and Balance Sheet)

Business Bank Statements - File Upload *

Click or drag files to this area to upload. You can upload up to 6 files.

Please upload 6 months business bank statements as either PDF versions or scan of the paper copies (CSV files not acceptable)

Additional Information

Please provide details of any other information you feel is relevant to this application. 750 characters max.

Captcha *

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