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Line of Credit Intake Form
Line of Credit Intake Form
Adrian Isalgue
2024-08-17T02:07:35+00:00
Applicant Information
Business Name
*
Applicant's Full Name
*
Title/Position
*
Business Address
*
Direct Phone Number
*
Email Address
*
Website
Next Section
Business Details
Type of Business Entity
*
Sole Proprietorship
Partnership
Corporation
Limited Liability Company (LLC)
Other
Other Type of Business Entity
*
Industry
*
Date Established
*
Annual Revenue
*
Number of Employees
*
Next Section
Credit Details
Requested Line of Credit Amount
*
Purpose of the Line of Credit
*
Working Capital
Purchase Inventory
Equipment Purchase
Expansion
Other
Other Purposes of the Line of Credit
*
Do you have any existing credit facilities?
*
Yes
No
Could you please provide details on existing credit facilities?
*
Next Section
Bank Statements
Bank Statements for the last 3 months and up to 12 months
*
Choose File
Drivers License
Drivers License
*
Choose File
Submit
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