1) Please tell us about your business loan or acquisition financing request in detail.




2) If this is a BUSINESS REFINANCING, please answer the following questions:
  What are your Company's current financing arrangements.
  What is your bank credit line?
  Are you being asked to leave the bank?
  When does your credit facility expire?




3) If this is a BUSINESS REFINANCING, please answer the following additional questions:
  What are your Company's current financials?
  Are you making or losing money?
  What are your assets and liabilities?
  What is your net worth?
  How would you like to structure this transaction?




4) If this is an ACQUISITION FINANCING, please answer the following questions:
  Why do you want to buy this company?
  How much cash are you coming in with to purchase the company?
  Which lenders have seen or are reviewing the deal?
  Which lenders have declined the deal?
  What is your experience in this industry?




5) If this is an ACQUISITION FINANCING, please answer the following additional questions:
  What is your net worth?
  Do you have the company's balance sheets and income statements?
  Is this company making or losing money?
  What are the company's assets and liabilities?
  How does the seller want to structure the sale?
  How would you like to structure this transaction?




Loan Amount: Select One $1,000,000 - $2,500,000 $2,500,000 - $5,000,000 $5,000,000 - $7,500,000 $7,500,000 - $10,000,000 $10,000,000 +


Location:   Select One Alabama Alaska Arizona Arkansas California Colorado Connecticut DC Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming


Financing: Select One Refinance Business Loan New Business Loan Acquisition Loan Secured: Accounts Receivable Secured: AR and Inventory Secured: AR, Invy, and Equipt Secured: Equipment Loan Secured: Inventory SBA Loan Revolving Line of Credit Working Capital Line of Credit Factoring Other


 First Name


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 Company Name


 Years In Business
Select One New Company less than 1 Year 1 - 3 Years 3 - 5 Years 5 - 10 Years more than 10 Years

 Job Title


 Address



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Select One Alabama Alaska Arizona Arkansas California Colorado Connecticut DC Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

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Secondary Phone


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