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Business Name: *

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Zip Code: *

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Loan Amount: *

Purpose of Loan: *

Nature of Business: *

Year Established: *

Number of Employees: *

Average Annual Sales (Past 3 years): *

Has your business been profitable at least 2 of the past 3 years?
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Owner 1

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Ownership Percentage: *

Approximate Credit Score: *

Owner 2

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