PYWS-Intake-Form

Lender Questionnaire

Solidus [Cash]
Name*

Lender First NameLender Last Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Spouse's Full Name
(If lending jointly)
Lender Business Name
(If using an LLC)
Duration of Note*
Select the option you prefer
Amount of note?*
In USD
By checking this box, I consent to allow Position Yourself Wealth Strategies and Solidus to communicate with me regarding the information provided. I acknowledge that the information shared does not include sensitive financial data. Furthermore, I confirm that I have read, understood, and agree to the Terms of Service, Privacy Policy, and Disclaimer of both Position Yourself Wealth Strategies and Solidus.*

I Consent
I Certify and Agree
Special Notes
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Lender Questionnaire