Request Loan Information
First Name
Last Name *
Email: *
Address 2:
Zip: mailing
Phone: *
Requested Loan Amount *
What do you need the loan for? *
Please rate your credit *
How many years has the business been in operation? *
How many years of industry experience do you have? *
For existing businesses: Do you think your business historically generates enough net income to easily cover this future loan and current existing debt? *
What County is your business located in? *
What zip code does your business primary operate in? *
If your business in not located in Florida what State is it located in?
If you talked to any Banks already let's take them out of the mix. Please list any bank(s ) you talked to:
What category best describes your business? *
Can loan be 100% secured by Real Estate? *
Is 51% or more of the business owned by U.S citizen(s) or a U.S. permanent resident aliens? *
For new businesses: Do you have additional sources of income that can help pay this loan? *
Please enter the sales price if most of the proceeds will be used to buy an asset
Complete the following two questions if you are buying or refinancing real estate
Real Estate: Will you occupy 51% or more of the property?
Real Estate: What type of property do you want to buy or refinance?
Complete the following 3 questions if you are buying or refinancing machinery or equipment with the loan proceeds
Machinery or Equipment: Interested in:
Machinery or Equipment: Type of Equipment:
Machinery or Equipment: Age of Equipment
Complete the following 2 questions if this is a business startup
Business Startup: Can you come up with at least 25% of the needed funds to start the business?
Clear selection
Business Startup: If no, for the above question, can you come up with 15% of the needed funds for the business?
Clear selection
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