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Asset Based Loan Application
Full Name
*
Full Address
*
Telephone
*
Email
*
Date of Birth
*
Ownership Percentage
*
BUSINESS INFORMATION
Business Name
*
DBA, Entity Type, Incorporation Date, & Industry:
Full Address
*
Business Phone
*
Website
*
Mobile Phone
*
Funding Needs
Amount of money you are seeking:
Describe the Asset:
Approximate Total Value of Asset:
*
If the asset is real estate, provide the type of property, present market value, mortgage balance, payment /month, & mortgage status.
Cash On Hand for Project:
*
Use of Funds:
ADDITIONAL INFORMATION YOU DEEM PERTINENT:
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