Form
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
State of Residence
Do you currently own a business?
Please Select
YES
NO
Do you know your current credit score?
Yes, it"s above 700
Yes, it"s between 600-699
Yes, it"s below 600
No, I don"t know
Have you missed any payments in the last 12 months?
What's your current credit utilization?
Less than 30%
Between 30%-50%
Over 50%
Do you have derogatory marks on your credit report(e.g., collection,charge-offs, bankruptcies)?
Please Select
yes
no
Do you have any open credit disputes?
How do you monitor your credit?
Credit Karma
Experian
Equifax
TransUnion
IdentityIQ
SmartCredit
Other
Have you formally established a business (LLC, corporation, etc.)
Do you have a business bank account? Where do you bank?
What is the primary reason you need business funding?
Please Select
Startup capital
Business expansion
Equipment or inventory purchase
Marketing and advertising
Other
How much funding are you seeking?
Please Select
$10,000 - $25,000
$25,000 - $50,000
$50,000 - $100,000
Over $100,000
What is your desired timeline for receiving funding?
Please Select
Within 30 days
1-3 months
3-6 months
More than 6 months
Are you willing to invest in improving your personal credit to qualify for business funding?
If yes, how much are you willing to invest in credit repair services?
Please Select
$0-$500
$500-$1,000
$1,000-$2,000
Over $2,000
What are your top three financial or business goals for the next year?
Do you currently have any income to support loan repayments?
Yes, from my business
Yes, from my personal income
No
Are you familiar with the business funding process?
Do you have a plan or strategy for how you will use the funding?
Are you open to a consultation to review your credit profile and funding options?
Submit
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