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Pre-Qualification Evaluation Survey
Step 1 of 4
Business Contact Information
Name of your business?
Consultant's Name or ID
1. What kind of business do you operate?
2. What industry does your company participate in?
3. Month and year business was started?
4. Is your business home-based?
5. How is your business classified?
Limited Liability Company (LLC)
S-Corporation (Small Business Corporation)
C-Corporation (Corporate Business)
6. Incorporated State:
Business Financial Profile
8. Is there a bank account in the business name?
10. What are the gross sales of the business Per Month?
11. Can you show 2 years of financial's for your business with good profits?
12. Do you know your personal credit scores?
What is your Equifax score?
What is your Experian score?
What is your Trans Union score?
13. Do you presently own real estate?
If so, what is the current market value of the property(ies)?
14. What is currently owed against the property(ies)?
15. Do you accept credit cards?
If yes, how much do you process each month in credit cards in USD?
16. Do you have any business assets such as:
Business Funding Eval
17. Amount of outstanding invoices with customers in USD:
18. Current amount of existing purchase orders in USD:
19. Total value of equipment owned outright in USD:
20. Do you have a breakdown for usage of funds?
List Usage and Amount:
21. Do you have a retirement/401k plan?
22. Total value of IRA & 401K investments in USD:
23. How much funding are you seeking?
23. How quickly do you need funding?
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Accepted file types: pdf, docx, doc, xlsx, xls.