We MicroFund You Application

- Business Owner Name*
  
  First NameLast Name
- Home Address*
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Contact Number*
  
  Country CodeArea CodePhone Number
- Email*
  example@example.com
- Social Security Number
- Please Upload Valid Identification*
  
  Passport, Valid Driver's License or other Valid State Identification (cannot be expired)
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- Do you have any other Business Partners or Co-Owners?*
  
  YesNo
- How Many?*
  
  OneTwoMore
- First Business Partner/Co-Owner Name*
  
  First NameLast Name
- First Business Partner/Co-Owner Address*
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- First Business Partner/Co-Owner Phone Number*
  Please enter a valid phone number.Format: (000) 000-0000.
- First Business Partner/Co-Owner Email*
  example@example.com
- First Business Partner/Co-Owner Social Security Number*
- Second Business Partner/Co-Owner Name*
  
  First NameLast Name
- Second Business Partner/Co-Owner Address*
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Second Business Partner/Co-Owner Phone Number*
  Please enter a valid phone number.Format: (000) 000-0000.
- Second Business Partner/Co-Owner Email*
  example@example.com
- Second Business Partner/Co-Owner Social Security Number*
- If more than three business partners and/or co-owners, please upload a spreadsheet or similar document with their names, addresses, phone numbers, emails and social security numbers.*
  
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- Upload Partnership or Operating Agreement*
  
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- Upload Board Resolution stating that you are allowed to obtain funding on behalf of your company.
  
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- Upload any other documentation and/or information we should know about your Business Partners/Co-Owners (i.e. divorce decree, bankruptcy discharge, etc.)
  
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- Upload All Business Owner/Partner Resumes*
  
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- Upload All Key Personnel Resumes*
  
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- Name of Business*
- Business Logo*
  
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- Business Email*
  example@example.com
- Business Phone Number*
  Please enter a valid phone number.Format: (000) 000-0000.
- If known, please provide your business's D-U-N-S number
- Business Address*
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Do you have a mailing address different than above?*
  
  YesNo
- Mailing Address*
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Does your business have multiple locations?*
  
  YesNo
- How Many?*
  
  TwoThreeMore
- Second Location*
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Third Location*
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- If your business has more than three locations, please upload a spreadsheet or similar document with listed addresses here.*
  
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- Please Upload Valid Business Registration and License*
  
  Cannot be expired
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- Please Upload a Letter of Intent, Lease, Deed, Purchase Agreement and/or Mortgage Statement for each business location*
  
  Also acceptable
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- Provide a brief description of the nature of your business.*
  
  0/100
- What products or services does your business offer?*
  
  0/50
- What is your target customer base?*
  
  0/50
- Who are your suppliers?*
  
  0/50
- Who are your competitors?*
  
  0/50
- What are your future plans for growth and/or expansion?*
  
  0/75
- Upload Existing Business Plan (if any)
  
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- What is your personal entrepreneurial story?
- List any major business accomplishments and/or milestones.*
  
  0/50
- Have you worked with a Small Business Support Agency or participated in any Business Training Program. If so, please list the names and dates of program(s) including the date of graduation. If not please enter "N/A". *
- Please tell us why you are applying for this loan. Select all that apply.*
  
  Real EstateConstructionBuild OutWorking CapitalVehicle PurchaseEquipment PurchaseRehabOther
- How much funding are you requesting for each?*
- If you were to receive this loan, describe how you would use it to benefit your company.*
- If you were to receive this loan, would you be creating any new employment opportunities? Please describe.*
  
  0/75
- Have you applied for funding from any other sources?*
  
  YesNo
- Please explain how much for each source*
- Upload Spreadsheet, or equivalent, showing the proposed uses of this loan and/or estimated project costs.*
  
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- Upload Personal Financial Information - Please provide an assets and liability statement*
  
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- Three Years Personal Federal Tax Returns*
  
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- Upload a Signed Form 4506-T to provide lenders*
  
  Below is a sample of what this form looks like
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- Please click here for IRS 4506-T Form & Instructions
- Copy of Bankruptcy Discharge (if any)
  
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- Copy of Divorce Decree (if any)
  
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- What range does your credit score fall into (If unknown, use a free software like Credit Karma to discover your score).*
  
  300-579: Poor580-669: Fair670-739: Good740-799: Very good800-850: Excellent
- Credit Explanation Letter (if any)
  
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- For those with little to no credit or bad credit, please provide Alternative Credit Letters (if any)
  
  Provide documentation letters of on-time payments (child support, monthly utility or other monthly bills, etc.)
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- Upload a list of personal collateral & it's value - MUST be in your name*
  
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- What is your current equity investment for this business?*
  How much have you invested in your business so far?
- Upload Business Financial Information - Please provide any assets or debt which your business currently has.*
  
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- THREE YEAR PROJECTION OF EARNINGS ** If you're requesting a term loan, 3-5 year projections are required. If you are requesting a line of credit you must submit 12 month cash flow projections. *
  
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- Upload Three Years Federal Tax Returns *
  
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- Upload a Signed Form 4506-T to provide lenders*
  
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- Please click here for IRS 4506-T Form & Instructions
- Create balance sheets here
- Upload Current Interim Balance Sheet*
  
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- Upload Past Three Years Balance Sheets*
  
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- Create income statements here
- Upload Current Income Statement*
  
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- Upload Past Three Years Income Statements*
  
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- Download a cash flow excel template here
- Upload Current Cash Flow Statement*
  
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- Upload Past Three Years Cash Flow Statements*
  
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- Find the break even analysis template that's right for you, here
- Upload a Break Even Analysis (If Applicable)
  
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- Download an accounts receivable template here
- Upload Current Accounts Receivable Aging (If Applicable)
  
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- Download an accounts payable template here
- Upload Current Accounts Payable Aging (If Applicable)
  
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- Upload Three Months Bank Statements for Main Operating Account*
  
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- Funding Amount Requested*
  
  1-15,00015,001-30,00030,001-50,000
- Do you need a term loan or a line of credit?*
  
  Term LoanCredit Line
- Do you need a payment grace period or interest-only payments?*
  
  YesNo
- Please select your preference of loan repayment*
  
  I can start making payments right awayI need interest only payments for a short timeI need a grace period with no payments for a short time
- I contest that you may pull my credit score along with any criminal and/or background checks, and use this information to apply on my behalf. Please Note: This information will NOT be used to withhold funding; as a matter of fact, it may be the opposite. This information may be used to advance you if you've met with legal challenges in the past.*
  
  I understand
- Signature of Business Owner Completing Form*
- Should be Empty: