Funding Pre-Qualified Questionnaire

Funding Pre-Qualified Questionnaire
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Referred By
Birthdate
Amount of Funding Needed? ( $10,000 -$400,000)
1. Are you a US Citizen?

YesNo
2. Do you reside in Iowa or California?

YesNo
3. Do you have a credit score 700 or highter on all 3 credit bureaus?

YesNo
4. Do You have at least 3 open Primary Tradelines reporting on your credit report?

YesNo
5. Is your income $32,000 or more Annually?

YesNo
6. Do you have less than 6 inquires in the past 6 months?

YesNo
7. Do you have new credit lines in the last 6 months? (credit card,credit card limit increase,car loan,mortgage,personal loans etc)

YesNo
8. Have you filed Bankruptcy?

YesNo
9. If you have filed Bankruptcy,is it at least 2 years discharged?

YesNo
10. Are you Employed or Self-Employed?

YesNoBoth
11. Have you been employed in your current position a minimum of 6 months with 1 year of consistant employment?

YesNo
12. Do you have any late payments,recent collections or any negative that is reporting in the last 2 years?

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

YesNo
14. Are you 72 years old or younger?

YesNo
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 kept confidential.
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