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Funding & Credit Assessment Form

Full Name

*

Email Address

*

Phone Number

*

What is your current personal credit score?

A

Below 580

B

580-700

C

700+

Do you currently have any of the following on your credit report?

*

Do you currently have any of the following on your credit report?

A

Late payments in the last 24 months

B

Charge-offs or collections

C

Repossession / foreclosure

D

Bankruptcy or public records

E

None of the above

Which best describes your current credit card utilization (how much of your limits you’re using) ?

*

Which best describes your current credit card utilization (how much of your limits you’re using) ?

A

Under 30%

B

30%–79%

C

80%+

D

I'm not sure

Do you have at least 4 open credit cards in your own name? (not Authorized user or builder accounts)

*

Do you have at least 4 open credit cards in your own name? (not Authorized user or builder accounts)

A

Yes

B

No

C

I'm not sure

How much funding are you looking to secure?

*

How much funding are you looking to secure?

A

Under $10,000

B

$10,000-$50,000

C

$50,000+

Do you currently have a registered business (LLC, Corp, etc.)?

*

Do you currently have a registered business (LLC, Corp, etc.)?

A

Yes

B

No

How long have you been in business?

*

How long have you been in business?

A

I haven’t started yet / just an idea

B

Less than 6 months

C

6–24 months

D

2+ years

Do you have a business bank account?

*

Do you have a business bank account?

A

Yes

B

No

Do you have an EIN (Employer Identification Number)?

*

Do you have an EIN (Employer Identification Number)?

A

Yes

B

No

What is your estimated monthly business revenue?

*

What is your estimated monthly business revenue?

A

Less than $5,000

B

$5,000 – $15,000

C

$15,000+

What do you plan to use the funding for?

*

What do you plan to use the funding for?

A

Working capital

B

Marketing/advertising

C

Equipment

D

Inventory

E

Business startup

F

Personal reasons

G

Other

When are you hoping to secure funding?

*

When are you hoping to secure funding?

A

Within 7 days

B

Within 30 days

C

60-90 days

What feels like your biggest obstacle right now?

*

What feels like your biggest obstacle right now?

A

Low credit scores / negative marks

B

High credit card balances / maxed utilization

C

No business structure or bank account

D

Not enough income / revenue on paper

E

I’ve been denied and don’t know why

F

I don’t know where to start

G

Other

Are you ready to invest in funding prep services if you qualify?

*

Are you ready to invest in funding prep services if you qualify?

A

Yes — I'm ready to invest in my business

B

Maybe — I need more info

C

No — I'm not in position to invest right now