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Loan Form
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1
Business Information
2
3
4
5
Personal Information
How Much Funding
*
Next
Monthly Revenue
*
$0
$1k-$4k
$5k-$9k
$10k-$29k
$30k-$74k
$75k-$149k
$150k-$249k
$250k-$499k
$500k-$999k
$1million +
Next
Use of Funds
*
Select One
Expansion
Equipment Purchase
Finance account receivable
Inventory
Marketing/sales
Payroll
Purchase Vehicles
Remodel Building
Refinance Dept
Working Capital/ Cash flow
Other
Next
Time in business
*
1-3 Months
3-6 Months
1-2 Years
2-4 Years
5+ years
Next
Name
*
First
Last
Email
*
Phone
*
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