Time in Business —Please choose an option—Under 6 Months6-12 Months1-2 Years2-4 YearsOver 4 Years

Monthly Revenue —Please choose an option—$10,000+$20,000+$30,000+$40,000+$50,000+$60,000+$70,000+$80,000+$90,000+$100,000+

Amount Requested —Please choose an option—below $10,000$10,000 -$20,000$20,000 - $40,000$40,000 - $60,000$100,000+

Working Capital Type (If Required) —Please choose an option—SBA LoanTerm LoanEquipment LoansLoan ConsolidationLine of CreditShort Term Bridge Loans

Credit Score —Please choose an option—750700+650+600+550+500+450+400+350+300+

Current Loan Status —Please choose an option—No Current LoansUp to DateDefaulted

Have you ever filed for bankruptcy? —Please choose an option—YesNo

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