Funding Pre-Qualification Questionnaire
Name
*
First Name
Last Name
Referred by
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Birthdate
*
-
Month
-
Day
Year
Date
Amount of Funding Needed ($10,000-$400,000)
*
Funding Purpose
*
1. Are you a U.S Citizen?
*
Yes
No
2. Do you reside in Iowa or California?
*
Yes
No
3. Do you have a Credit Score of 660 or higher on all 3 credit bureaus?
*
Yes
No
4. Do you have at least 3 open tradelines reporting on your credit report?
*
Yes
No
5. Is Your Income $27,000 or more Annually?
*
Yes
No
6. Do you have less that inquiries in the last 6 months?
*
Yes
No
7. Do you have new credit lines open in the last months (credit cards, credit card limit increases, car loan, mortgage, personal loan etc?)
*
Yes
No
8. Have you ever flied for bankruptcy?
*
Yes
No
9. If you have filed bankruptcy, is it at least 2 yrs. discharged?
Yes
No
10. Are you employed or self-employed?
Employed
Self-Employed
Both
11. Have you been employed in your current position a minimum of 6 months?
Yes
No
12. Do you have any late payments, recent collections, or anything that is derogatory reporting that is reporting in the last two years?
Yes
No
13. Do you have at least 50% left on your current credit card balances?
Yes
No
By submitting this form, you agree that the information provided is correct to your knowledge. The information provided in this application will not be shared and is kept confidential.
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