Semaj Financial Loan Application

LOAN QUESTIONAIRE
Applicant Information
Name of Business
Name of Person Representative
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Years in Business
Position
Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
New ClientExisting ClientOther
Business Email
example@example.com
Industry of Business
Loan Information
What's Your Fico Score
Loan Amount Request
Asset Based LoanBusiness LoansBusiness Working CapitalCommercial Real EstateEquipment FinancingMicro LoansRevolving Line of Credit
Purpose of your Loan
Income Summary
Monthly Revenue Sales
Monthly Expenses
Any Insufficient Funds Last 90 Days?
Name
If Commercial Real Estate Enter The Type
Estimate Value Of Property
YESNO
Property Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date Signed

MonthDayYear
Date
Should be Empty:

LOAN QUESTIONAIRE