Loan Prequalification Questionnaire

First Name *

Last Name *

Email *

Phone *

Tell us about your business debt

Do you have any open business debt? i.e. business loans, equipment, business credit cards etc. *

Yes

If so, how much?

When did you establish your company? *

State of formation

Tell us about your business cashflow

If applicable, what were the average total monthly deposits on your business bank statements over the past 3 months? *

For instance, if the revenue for the last three months was $20,000, $30,000, and $40,000 respectively, the average monthly revenue would be $30,000.

Tell us about your loan preferences

What type of loan are you interested in? *

Tell us about you funds usage

If you had access to $50,000 to $500,000 -- how would you use your funds (Check all that apply)? *

How would you use the funds (Specify if other)

Personal Financial Profile

What was your personal annual income in 2024? *

What is your current employment status? *

W2 wage earner

Self-employed

Unemployed

Other

Employment status (Specify if other)

What’s your address?

Address

Street Address *

City *

State *

Postal code *

Credit Authorization

Social Security Number *

Please Sign *

Clear

Credit authorization disclaimer (AT THIS STAGE, WE WILL ONLY PULL A SOFT INQUIRY, THIS WILL NOT AFFECT YOUR CREDIT SCORE) :

By signing below, each of the above-listed business and business owner/officer (individually and collectively, “you”) authorize its representatives, successors, assigns and designees (“Recipients”) that may be involved with or acquire commercial loans, including without limitation the application therefor (collectively, “Transactions”) to obtain consumer and/or personal, business and investigative reports and other information about you, including credit card processor statements and bank statements, from one or more consumer reporting agencies, such as TransUnion, Experian, and Equifax, and from other credit bureaus, banks, creditors and other third parties. You also authorize us to transmit this application form, with any of the foregoing information obtained in connection with this application, to any or all of the Recipients for the foregoing purposes. You also consent to the release, by any creditor or financial institution, of any information relating to any of you to each of the Recipients, on its own behalf. I am providing my cellphone number and hereby consent to the receipt of text messages knowing that msg. and data rates may apply. I understand that consent to receive texts is not a condition of approval. I/We certify that all the information contained herein is complete, true, and accurate.

Thank you for completing

the Loan Prequalification Questionnaire.

Please click the SUBMIT button to complete your submission.

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