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Let's Get You Funded!

Business Funding Client Intake Form.
Name of Applicant*

First NameLast Name
E-mail of Applicant*
example@example.com
Phone number of Applicant*
Format: (000) 000-0000.
Are You Applying for Business or Personal Funding?

Personal FundingBusiness Funding
Business Details

Provide basic information about your business to help us understand your company profile.
Legal Business Name:
Business Structure:

Sole ProprietorLLCCorporation (C-Corp/S-Corp)Non-ProfitOther
Business Industry:
State of Operation:
Length of business:
Business Bank Account?

YesNo
Funding Snapshot

These details help us pre-qualify you for the most suitable business funding options.
Average Monthly Business Revenue:
Amount of Funding You're Seeking:
Primary Use of Funds:

Working CapitalExpansionEquipmentPayrollMarketingReal EstateStart-Up CostOther
Credit Profile Information

Please provide the following information to support the pre-qualification process.
Do you have a copy of your credit report dated within the last 30 days?

YesNo
If available, please upload your most recent credit report (PDF preferred). Providing this will help us assess eligibility and determine the best funding options for you.

Cancelof
Estimated Personal Credit Score:

500 or below501-599600-649650-699700+
Have you ever filed for Bankruptcy?

YesNo
Consent & Authorization

You must authorize us before we can proceed with your application.
Consent to Contact:

By submitting this form, I give DDH Business Firm, LLC permission to contact me by email. phone, or SMS regarding funding options and related services.

Authorization:

I Authorize DDH Business Firm, LLC to review my information for funding purposes and to act as my representative when assisting with funding inquiries and applications.
I have read and agree to the above.

Yes
Name

First NameLast Name
Signature
Date

MonthDayYear
Date
Should be Empty:

Let's Get You Funded!

Business Details

Funding Snapshot

Credit Profile Information

Consent & Authorization