Louisiana Opportunity Capital Micro Lending Program Eligibility Screening Form

Louisiana Opportunity Capital Micro Lending Program Eligibility Screening Form

Answer a brief set of questions to determine whether you may be eligible and what review steps apply. Estimated completion time: 5 minutes.
Business Information
Legal Business Name
DBA / Trade Name
Business Phone
Please enter a valid phone number.Format: (000) 000-0000.
Business Email
example@example.com
Business Website
Employer Identification Number (EIN)
Business Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Contact Person Name

First NameMiddle NameLast Name
Contact Person Title
Business Structure & Eligibility
Business entity type
Do all owners meet the citizenship or permanent residency requirement?
Business Location & Geography
Is the business registered in Louisiana?
Does your business currently maintain an office or operate in Louisiana?
Business History
How long has your business been operating?
Number of Current Employees—can include the owner of the business
Employment Impact
Estimated Annual Revenue
Current Operating Status
What was your business's gross annual revenue reported on your 2025 tax return?
What was your business's net income reported on your 2025 tax return?
What is your business's average monthly debt payment (if applicable)?
What is your annual salary or owner's compensation received from the business (if applicable)?
Industry Eligibility
What industry best describes your business?
Does your business operate in any of the following industries?
Financing Request
Requested Loan Amount (Loans greater than $50,000 require eligible collateral.)
Intended Use of Funds

Other
Are any loan proceeds intended for the following purposes?
Describe Intended Use(s) of Funds
How did you hear about TruFund?

Other
Applicant Certification
Certification Statements
Certifying Name

First NameLast Name
Signature and Date
AutomationStatus
Should be Empty:

Louisiana Opportunity Capital Micro Lending Program Eligibility Screening Form

Business Information

Business Structure & Eligibility

Business Location & Geography

Business History

Industry Eligibility

Financing Request

Applicant Certification