Loan Questionnaire
Carolyn Coke 754-300-7789
Todays Date
*
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Month
-
Day
Year
Date
Name of Applicant
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First Name
Last Name
E-mail
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Phone number
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Area Code
Phone Number
Business Name (If Applicable)
Industry of Business
*
Years in Business
*
Monthly Revenue Sales
*
Provide a brief description of your loan scenario or any additional info we should know:
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Address of Subject Property or Business
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What type of loan are you looking for?
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Commercial Real Estate
SBA
Purchase Order Financing
Residential Investment Property
Equipment Financing
Business Working Capital
Business Line of Credit
A/R Factoring
What's Your Fico Score
*
Please Select
500-550
551-601
602-850
Loan Amount Request
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What is the time frame of needed funds?
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Citizenship
*
US Citizen
ITIN
PRA
Other
Are you a homeowner?
Yes
No
Submit my application
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