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How Much Funding Do You Think You Will Need?
$10K - $20K
$20K - $50K
$50K - $75K
$75K - $100K
$100K - $150K
$150K - $200K
$200K - $300K
$300K - $500K
$500K - $1MM
$1MM - $1.5MM
$1.5MM - $2MM
$2MM - $3MM
$3MM - $5MM
$5MM - $10MM
$10MM +
How Soon Do You Need The Money?
Immediately
Within the next 2 weeks
Within the next 30 days
Over 30 days from now
Use Of Funds
Business Expansion
Inventory
Marketing & Advertising
Payroll
Purchase Equipment
Real Estate
Refinancing / Consolidating Debt
Taxes
Working Capital
Other
Name
*
First
Last
Company
*
Best Contact #
*
Email
*
Annual Gross Sales / Revenue
$0 - $59K
$60K - $99K
$100K - $149K
$150K - $249K
$250K - $499K
$500K - $1.99MM
$2MM - $4.99MM
$5MM +
Credit Quality
800 +
700 - 799
650 - 699
600 - 649
550 - 599
500 - 549
Below 500
Unknown
Time In Business
Pre Revenue / Start Up
Less Than 3 Months
3 - 5 Months
1 - 2 Years
2 - 5 Years
5 - 10 Years
10 - 20 Years
20 - 30 Years
30 Years +
Any Additional Information You Would Like Us To Know
Name
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