Pre-Approval Questionnaire
Specialty Business Funding Program: $25k to $200k In 5-7 Business Days
Owner's Name:
*
First Name
Last Name
Legal Business Name:
*
Ex: J.L. Smith Enterprises, LLC.
DBA:
*
Ex: Joe's Pizzeria
Business Address:
*
*(P.O. Box's, Mailbox Addresses, UPS (Type) Stores, Shared or Virtual Offices etc. Will Not Qualify)
Suite/Unit #
City
State
Zip Code
Business Phone Number:
*
-
Area Code
Phone # *Google Voice #'s or Alternate (Type) of #'s Will Not Qualify.
Cell Phone Number:
*
-
Area Code
Phone # *Google Voice #'s or Alternate (Type) of #'s Will Not Qualify.
Email Address:
*
example@example.com
1) This program is for U.S. based businesses only. Are you a U.S. based business?
*
Yes
No
2) How long has your business been open?
*
Type time in business Ex: 7.5 years
3) Do you have a personal credit score 680+ or higher?
*
Yes
No
I don't know
4) Does your business have a Paydex Score of 70+ or higher?
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Yes
No
I don't know
5) Does your business have any open judgements against it?
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Yes
No
6) What is your average gross monthly revenue?
*
Ex: $40,000.
7) Is your business currently in or have ever been in bankruptcy?
*
Yes
No
8) Which best describes your physical business address?
*
Brick & Mortar
Home-Based
Online (Internet Based)
UPS Store, Mail Store or P.O. Box
9) Within the last 7 years does your business have any of the following successful transactions: (click all that apply)
*
A true bank loan
A true bank line of credit
An equipment lease or finance
All of the above
None of the above
10) Are you open to a creative financing vehicle that will not interfere with your ability to qualify for additional funding?
*
Yes
No
11) Does your business have 3 or more recently defaulted MCA payments (within the last 30 days)?
*
Yes
No
12) Has your business ever had a total MCA default?
*
Yes
No
13) Are you interested in 5 year funding payback with monthly payments?
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Yes
No
14) Do you have a D&B Business Credit Profile?
*
Yes
No
15) What is your Dun & Bradstreet # ?
16) How much capital are you seeking?
*
Type $ Dollar amount of loan
Purpose of Funds?
*
How will you use the proceeds?
Referred By:
Who referred you?
Please verify that you are human
*
Submit
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