General Intake Form

Name *

Home Address *

City

State/Province

ZIP / Postal Code

Country

Date of Birth *

SSN *

Annual Income *

Email Address *

Tel *

Business Name *

EIN Number *

Business Start Date *

State of Incorporation or LLC *

Company Email *

Company Tel *

Company Website *

Duns Number *

Business Gross income for the previous 2 years *

Have you filed taxes? *

How many employees do you have? *

Do you have any corporate equipment? *

Do you have any corporate credit established?

Credit cards

Vehicles Loans

Does your corporation own any real estate? *

Percentage of ownership *

What bank(s) does your business bank at?

Bank *

What are your average business account balances? *

How do you accept payments? *

How many checks do you write per month? *

What is your average service cost? *

Who is your credit card provider? *

Do you accept credit cards? *

How much will your opening deposit *

How much is your rent or mortgage payment for your business? *

How much is your rent or mortgage payment at your home? *

Is you rent or mortgage shared? *

Housing portion of the rent? Business Portion of the rent? *

Where do you bank personally

Bank *

What kind of balances do you carry? *

Do you have a 401k or 403b? *

How much is in the account? *

USD

Do you have annuities, ira accounts, stocks, bonds, mutual funds and how much cash do you have in the bank at all banks personal and business?Please provide Username and Pw case sensitive and the website we can access your report for review without having to do a hard inquiry.

Is your business active and in good standing? *

What do you anticipate your monthly credit spend limit will be? *

Personal Profile

Name *

Phone *

Email Address *

Street Address

City

State/Province

ZIP / Postal Code

Country

Driver license number/issue date/exp date *

Employer *

Years on Job *

Annual Income *

Position on job *

Where do you bank personally & Balance in accounts?

Bank Name *

Balance in Account *

Do you have any partners or friends who will potentially partner with you who have good credit? *

Can you use another person’s income who has good credit to qualify for more funding? *

If yes. Please have them to register with creditkarma.com and identityiq.com and submit the following just like you.

Username *

Password *

Last 4 of SSN *

How much capital are you seeking? *

How soon do you need it? *

Interested in a million-dollar retirement plan with a 100k passive income plan for life? *

Would you like to be business branded and create successful imaging? *

Business Funding

Personal Loans

Real Estate Funding

Publications

Photo Gallery

Events

Press Release

Exclusives Homes