GemSource Capital Prequalification Application

GemSource Capital Prequalification Application

This application is the first step toward unlocking capital from your assets. Please complete the secure form for our team's preliminary review, after which a GemSource Capital representative will contact you with an update.
Enter Full Legal Name*

First NameLast Name
Enter Email*
example@example.com
Enter Phone Number*
Please enter a valid phone number.
Enter Business Name*
Business Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Select Business Type*

Private Limited CompanyPublic Listed CompanyCooperativeSole ProprietorshipPartnershipOther
Select Your Primary Industry Role*

Retail JewelerDiamond WholesalerJewelry Designer / ManufacturerPrivate Dealer / BrokerPrivate Investor / CollectorOther
Select the Number of Years in Business*

< 1 Year1-3 years3-5 years5+ years
Estimated Annual Revenue*
EIN (XX-XXXXXXX)*
Collateral Section
Enter GIA Report Number*
Enter the Estimated Value of Assets*
Please upload GIA certification document(s). Maximum two files per upload.*

Cancelof
Is the GIA number laser-inscribed on the diamond's girdle?*

YesNoUnsure
Loan Section
Select the Purpose of Loan*

Working CapitalExpansionInventory PurchaseRefinancingOther
Enter Loan Amount Requested*
Funding is typically completed within 48-72 hours of asset verification. Please select your required timeline below.*

Less than 15 days15 days - 1 month1 -3 months
Have you pledged this asset to another lender?*

YesNo
Please provide any additional information regarding your financing needs, including specific transaction deadlines, deal structures, or other relevant details.
How did you hear about GemSource Capital?*

Referral from an Industry ColleagueDirect Outreach from the GemSource TeamOnline Search (Google, etc.)Trade Publication (e.g., Rapaport, JCK)Social Media (Instagram, LinkedIn, etc.)Other (Please specify)
Agreement to Terms: Please review and accept the following terms to complete your submission.
I hereby certify that all information provided in this submission is true, correct, and complete to the best of my knowledge and belief.

I hereby certify that all information provided in this submission is true, correct, and complete to the best of my knowledge and belief.
I consent to being contacted by a GemSource Capital representative via the email address and/or phone number I have provided to discuss this submission.*

YesNo
Legal Disclaimer
By submitting this form, you acknowledge and agree that this is a preliminary request for information and not a formal loan application or a commitment to lend. Any offer of credit is subject to, but not limited to, satisfactory in-person collateral verification, underwriting review, successful completion of Know Your Customer (KYC) and Anti-Money Laundering (AML) checks, and the execution of definitive legal agreements.

We will not perform a hard credit pull. You may opt out of communications at any time.
Once you have read and understood the information, confirm your acceptance by checking the box below and submitting this form.

I acknowledge that I have reviewed and understand the terms outlined above, and I accept these terms as a condition of submission.
By clicking "Submit," you acknowledge and agree to the GemSource Capital [Terms of Use]and [Privacy Policy].
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GemSource Capital Prequalification Application

Collateral Section

Loan Section

Agreement to Terms: Please review and accept the following terms to complete your submission.

Legal Disclaimer