Application Intake Formwpadmin2022-12-13T07:24:54+00:00

BUSINESS FUNDING APPLICATION

Step 1 of 4

25%

Date
Name
First Last
Mobile Phone*
Email
Funding Options*
Intended Use of Funds:*
Funding Requested:
Business Contact Information
Legal Business Name:*
State of Incorporation:*
Tax ID:*
Doing Business As (DBA):

Business Profile
1. What kind of business do you operate?*
2. What industry does your company participate in?*
3. Month and year business was started?
4. Is your business home-based?
5. How is your business classified?*

Business Financial Profile
8. Is there a bank account in the business name?*
10. What are the gross sales of the business Per Month?
11. Can you show 2 years of financial's for your business with good profits?
12. Do you know your personal credit scores?
What is your Equifax score?
What is your Experian score?
What is your Trans Union score?
13. Do you presently own real estate?
If so, what is the current market value of the property(ies)?
14. What is currently owed against the property(ies)?
15. Do you accept credit cards?
If yes, how much do you process each month in credit cards in USD?
16. Do you have any business assets such as:
- Equipment
- Inventory
- Purchase Orders
- Account Receivables
- No

Business Funding Eval
17. Amount of outstanding invoices with customers in USD:
18. Current amount of existing purchase orders in USD:
19. Total value of equipment owned outright in USD:
20. Do you have a breakdown for usage of funds?
List Usage and Amount:
21. Do you have a retirement/401k plan?
22. Total value of IRA & 401K investments in USD:
23. How quickly do you need funding?*
Attachments
Drop files here or

Accepted file types: pdf, docx, doc, xlsx, xls.