Business Credit and Funding
Name of your Business
Consultant Name or Rep ID# Who referred you?
Please select which product(s) you are interested in receiving a free assessment and/or additional Information
Business Credit (assessment available)
Business Funding (assessment available)
Business Debt Elimination (assessment available)
Digital Marketing Services (assessment available)
Incorporating Services (assessment available)
Discount Medical & Dental Savings Program
1. What kind of Business do you operate?
2. What industry does your comapny participate in?
3. Month and year business was started:
4. Is your business home-based?
5. How is your business classified?
6. Incorporate State:
7. How many employees do you have?
8. Is there a bank account in the business name?
9a. What are the gross sales of the business Per Year?
9b. What are the gross sales of the business Per year?
10. Can you show 2 years of financial’s for your business with good profits?
11. Do you know your personal credit scores?
If so, what are they?
(Enter each below)
12. Do you presently own real estate?
If so, what is the current market value of the property(ies)?
13. What is currently owed against the property(ies)?
14. Do you accept credit cards?
If yes, how much do you process each month in credit cards?
Would you like a FREE Analysis to determine if we can lower your merchant processing rates?
15. Do you have any business assets such as:
16. Amount of outstanding invoices with customers:
17. Current amount of existing purchase orders:
18. total value of equipment owned outright:
19. Do you have a breakdown for usage of funding?
If so, please list usage & amount:
20. Do you have aretirement/401K plan?
21. Total Value of IRA & 401K investments:
22. How much funding mare you seeking?
23. Is your business a for profit or non-profit business
24. How quickly do you need funding?
25. Would you like to receive additional information?
26. Do you currently have an online digital marketing partner to manage your online and social media presence?
27. Would you like a free debt reduction analysis to determine the quickest and most cost effective way to become debt free and receive your “Debt free” Date
28. If No would you like to receive a complimentary digital marketing evaluation for your businessses goals.
Best method and time to contact you
Click to upload your filer here.
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