Borrow Funds Preliminary Questionnaire

Question Title

* 1. Contact Information

Name *

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Country

Email Address *

Phone Number *

Question Title

* 2. What amount of funds are you seeking?

$10,000 or less

$10,000-$100,000

$100,000-$250,000

$250,000-$1,000,000

$1,000,000+

Question Title

* 3. What will the funds be used for?

Question Title

* 4. What amount of your own funds will be used in this transaction?

I am not planning on using any of my funds.

$1-$10,000

$10,000-$100,000

$100,000-$250,000

$250,000-$1,000,000

$1,000,000+

Question Title

* 5. What is your timing for this investment?

Within the next 14 days.

Within the next 30 days.

Within the next 60 days.

Later than 60 days.

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* 6. What is your approximate credit score?

Less than 669

670-739

740-799

800-850

Question Title

* 7. What collateral is available to secure the loan?

No collateral available.

Collateral available.

Please explain available collateral.

Borrow Funds Preliminary Questionnaire

Question Title

* 1. Contact Information

Question Title

* 2. What amount of funds are you seeking?

Question Title

* 3. What will the funds be used for?

Question Title

* 4. What amount of your own funds will be used in this transaction?

Question Title

* 5. What is your timing for this investment?

Question Title

* 6. What is your approximate credit score?

Question Title

* 7. What collateral is available to secure the loan?

Question Title

* 8. Feel free to provide additional detail.