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Email
*
Business Name:
*
Address:
*
City/Town:
*
State:
*
Zip Code:
*
Phone:
*
Website:
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?
Profitable 2019
Profitable 2018
Profitable 2017
Owner 1
Name:
*
Address (City, State, Zip Included):
*
Ownership Percentage:
*
Approximate Credit Score:
*
Owner 2
Name:
Address (City, State, Zip Included):
Ownership Percentage:
Approximate Credit Score: