National Capital Funding Group LLC
Investing into the passions, dreams, and desires of business owners
Project Assesment Form
Name
Company Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
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Capital Needs Analysis
What is the process for obtaining a budget for a decision like this?
Money on hand
Money from friends and family
Money from budget
Other
What is your implementation date?
Few months
Few Weeks
Immediately
Other
What are your greatest concerns growing your business?
Marketing and advertising
Equipment purchasing
Secure working capital
Business expansion investment capital
How long have you been in business?
Less than 2 years
Less than 4 years
Less than 8 years
Less than 10 years
What is your business structure?
Incorporated
Limited Liability Company, LLC
501-c2(Nonprofit)
Sole Proprietorship
Other
What is your business location?
Home office
Brick and Mortar
Virtual Office
Other
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Nature of Business
Which of these does your business currently have?
Phone and fax
Phone, Fax, Website
Business Email
All of the above
Does your business have a business credit profile setup on each of the credit bureaus?
D n B
Experian
TransUnion
Equifax
Other
Does your business have credit scores?
Padex
Intelliscore
Equifax
My business does not have scores
Does your business have verifiable trade lines?
Yes
No
If your business does have lines of credit are they secured or unsecured?
Secured
Unsecured
Neither
Has your business pass through compliance to determine if all local , state and federal requirements are in place?
Yes
No
None
Some
Does your business have assets?
Yes
No
Some
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Types of Assets
Cash on hand
$
Savings accounts
$
Life Insurance – Cash Surrender Value Only
$
Marketable Securities
$
IRA or Other Retirement Accounts
$
Stocks & Bonds
$
Real Estate
$
Company Automobiles – Present Value
$
Other Income
$
Other Assets
$
Liabilities
Accounts Payable
$
Notes to Payable to Banks & Others
$
Installment Account (Auto) Monthly Payments
$
Other installment Accounts
$
Loan on Life Insurance
$
Mortgages on Real Estate & Balances
$
Unpaid Taxes
$
Other Liabilities
$
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Annual Sales Revenues
Annual Sales Revenues
$
Do you have any debts that have been discharged, compromised or settled under Bankruptcy Code?
$
Rate your personal credit:
Poor - Under 600
Fair - 640
Good - Over 640
Excellent - 730+
I don't know
Does your business have a merchant account?
Yes
No
Neither
Does your business have a financials?
Yes
No
How many employee do you have?
How much money do you need and for whatpurposes?
Rows
$$
• Land Acquisitions
• New Construction
• Expansion Repair
• Acquisition of Machinery & Equipment
• Inventory Purchase
• Working Capital
• Acquisition of Existing Business
Do you have the support of family & friends?
Yes
No
What’s your definition of SUCCESS?
How/Where Did You Find Us:
Google
Yahoo
Word of Mouth
Other
If you have any other information that you feel is important please share:
National Capital Funding Group LLC
220 2nd Ave Seattle WA. 98104
Ph: (206) 257-2258
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