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Business Funding Request Analysis

How did you hear about us? *
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Business Name *
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City *
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State *
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Name
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Required First Required Last
Email *
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Phone *
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How long have you been in business? *
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what is your corporate entity structure? *
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Do you have any outstanding debts or loans for your business? *
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Total amount of debt USD *
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Enter 0 if you do not have any outstanding debt.
What are your monthly expenses? USD *
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Enter 0 if you do not have any outstanding debt.
Have you declared bankruptcy recently? *
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Date of Bankruptcy
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dd-MMM-yyyy
Is your business cash flowing now? *
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What was your business income in the last 12months? USD *
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Enter 0 if you do not have income coming in from your business.
What was your personal income in the last 12 months? USD *
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Enter 0 if you do not have income coming in from your business.
What is your personal credit score? *
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Please enter a score #
What are the top 3 goals you want to accomplish in the next 6-12 months? * *
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Are you ready to move forward with you loan? *
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This amount will vary depending on the type of loan you are looking for.
If we can qualify you for more than what you are asking for would you be open to it? *
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This amount will vary depending on the type of loan you are looking for.
Loan Amount Needed? USD *
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If needed, do you have collateral to pledge in consideration for your loan? *
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Please list the item. All collateral considered, Real estate, stocks, bonds etc.
Please provide us with a detailed summary of what you are trying to do, what the proceeds from the loan will be used for. *
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File Upload
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Upload file
This form is for pre-qualification only, do not upload any financial documents here. If you have documents you wish to share, upload them here. I.e. business plans, executive summary or pictures of collateral.
How do you plan to repay the loan? *
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What are you biggest challenges you feel are holding you back? *
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Can you produce the last 2yrs. financials to document your current cash flow *
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Banking statements and or tax returns from previous 2 years, business or personal
Documents Needed *
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Depending on the program we place you in, one or more of the following documents will be needed. Please check the ones that you will be able to provide.
If you have documents that are not listed here please explain.
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Do not submit confidential information such as credit card details, mobile and ATM PINs, OTPs, account passwords, etc.Report Abuse

Business Funding Request Analysis

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