Personal Loan Pre-Qualification Form

I'm Ready To Fund My Dreams

Funding Pre-Qualification Questionnaire
Funding Pre-qualification Questionnaire

Please Complete The General Information Form and a representative will be in contact with you within 48 hours. We look forward to doing business with you. Thank you for inquiring with Xtreme Financial Group where we take your Financial Makeover to the Xtreme! Talk To You Soon!
Client Information
1. Name*

First NameLast Name
2. Referred by*

First NameLast Name
Last NameSuffix
3. Email*
example@example.com
4. Phone*
Phone Number
5. Date of Birth*

MonthDayYear
6. Amount of Funding Needed ($10,000 - $400,000)*
7. Funding Purpose*
8. Are You A U.S Citizen*

YesNo
9. Do you reside in Iowa or California?*

YesNo
10. Do you have a credit score of 660 or higher on all 3 credit bureaus?*

YesNo
11. Is your annual income $30,000 or more?*

YesNo
12. Do you have at least 3 open tradelines reporting on your credit report?*

YesNo
13. Do you have less than 6 inquiries in the last 6 months?*

YesNo
14. Do you have new credit lines open in the last 6 months (credit cards, credit card limit increases, car loan, mortgage, personal loans, etc?)*

YesNo
15. Have you filed Bankrupty within the past 2 years?*

YesNo
16. Are you currently employed or self-employed?*

EmployedSelf-employedBothRetired
17. Have you been employed in your current position a minimum of 6 months?*

YesNo
18. Do you have any late payments, recent collections, or anything that is derogatory reporting on your credit report in the last two years?*

YesNo
19. Do you have at least 60% left on your current credit card balances?*

YesNo
20. I agree that the information herein is true and correct*

YesNo
Signature*

Clear
Verification*
The information provided in this form will not be shared and is kept confidential.
Should be Empty:

I'm Ready To Fund My Dreams

Client Information