Pre Qualification

1

Name * This field is required.

First Name

Last Name

2

Email* This field is required.

example@example.com

3

Phone Number* This field is required.

Area Code

Phone Number

4

Birthdate * This field is required.

Date

5

Funding Purpose * This field is required.

6

Amount of Funding Needed (10,000 -400,000)* This field is required.

7

Are you a U.S Citizen?* This field is required.

Yes

No

8

Do you reside in Iowa or California?* This field is required.

Yes

No

9

Are you Employed or Self- Employed?* This field is required.

Employed

Self-Employed

Both

10

Is your income $27,000 or more Annually?* This field is required.

Yes

No

11

Have you been employed in your current position a minimum of 6 months?* This field is required.

Yes

No

12

Do you have a Credit Score of 660 or higher on all 3 credit bureaus?* This field is required.

Yes

No

13

Do you have any late payments, recent collections or anything derogatory that is reporting in the last 6 months?* This field is required.

Yes

No

14

Do you have at least 3 open tradelines reporting on your credit report? (Credit cards, car loan, mortgates, etc)* This field is required.

Yes

No

15

Do you have new credit lines in the last 6 months (credit cards, credit card limit increases, car loan, mortgage, personal loan etc)?* This field is required.

Yes

No

16

Have you filed Bankruptcy?* This field is required.

Yes

No

17

If you have filed Bankruptcy, is it at least 2 years discharged?* This field is required.

Yes

No

18

Do you have at least 50% left on your current credit card balances?* This field is required.

Yes

No

19

By submitting this form, you agree that the information provided is correct to your knowledge.* This field is required.

Yes