njsbdc

Loan Pre-Qualification Survey
Required Required Question(s)
LOAN PRE-QUALIFICATION ASSESSMENT Please help us serve you better by taking a few moments to fill out this survey form.This survey will give us a preliminary assessment of where you financially stand in the loan application process. All financial information can be completed using estimates and will be kept confidential.
 
Required 1.
Please enter the information indicated below.
First Name:
Last Name:
Company Name:
Work Phone:
Email Address:
emailaddress@xyz.com
Address 1:
Address 2:
City:
State/Province
(US/Canada):
Postal Code:

2.
Description of Business
 

  • 350 character(s) left.
3.
% of Ownership
 

  • 50 character(s) left.
4.
Start-up Date
 

  • 50 character(s) left.
5.
Type of Legal Entity
Sole Proprietor
LLC
Partnership
Corporation
6.
Loan Amount Requested
 

  • 350 character(s) left.
7.
Purpose of Loan
Working Captial
Inventory
Equipment
Vehicle
Other real estate
Other  
8.
Do you own any assets that can be pledged as collateral (only assets that you own outright can be considered as collateral)?
Yes
No
9.
If you answered 'Yes' on question 8, then please indicate:
Business Assets
Home
Vehicles
Other real estate
10.
What is your total monthly income from all household sources?
 

  • 350 character(s) left.
11.
What are your total monthly expenses?
 

  • 50 character(s) left.
12.
What are the average gross monthly sales of your business?
 

  • 350 character(s) left.
13.
What are the average gross monthly expenses of your business?
 

  • 350 character(s) left.
14.
What is the estimated value of your personal assets? Please indicate a) Cash, Checking & Savings: b) Real estate (market value): c) Life Insurance (cash surrender value): d) Bonds, Stocks, Etc: e) Automobile (market value): f) Other assets:
 

  • 500 character(s) left.
15.
What are estimated personal liabilities? Please indicate the amounts below. a) Total credit card balance: b) Total bank loan balance: c) Total auto loan balance: d) Total mortgage balance: e) Total student loan balance: f) Other liabilities:
 

  • 500 character(s) left.
16.
Have you and/or the business ever filed bankruptcy? Please comment if you select 'Yes'
Yes
No
  • Comment:

  • 500 character(s) left.
17.
Do you have any collection items or unpaid taxes? If Yes, please explain in comment box
Yes
No
  • Comment:

  • 500 character(s) left.
18.
Do you have any pending police, public, or legal issues? If Yes, please explain in comment box.
Yes
No
  • Comment:

  • 500 character(s) left.
19.
Are you or your business involved in any lawsuits? If Yes, please explain in comment box.
Yes
No
  • Comment:

  • 500 character(s) left.
20.
Do you owe any outstanding child support?
Yes
No
21.
Have you ever defaulted on a federal government contract or student loan?
Yes
No
22.
Is your business for profit or a non-profit entity?
Yes
No
23.
Do you have proof of owner equity (i.e. Cash to invest/receipts of business purchases)?
Yes
No
24.
Do you have a completed written business plan with 2 years of cash projections?
Yes
No
25.
Are you a US citizen, or do you have a green card or other proof of residence?
Yes
No
26.
Have you had 3 or more months of sales or do you have contracts for future sales?
Yes
No
27.
Do you or someone in your household have a secondary source of income?
Yes
No
28.
Did your business make a profit last year?
Yes
No
29.
Do you have formal training/experience in your field of business?
Yes
No
30.
Have you had any personal or business bank accounts with checks returned due to non sufficient funds?
Yes
No
31.
Do you own real estate (excluding your residence)?
Yes
No
32.
Are you currently paying off a vehicle purchase or lease?
Yes
No
33.
Is there another person who is willing to guarantee your loan?
Yes
No
34.
Will a credit report show that you have been current with creditors over the past 2 years?
Yes
No
35.
Have you addressed any derogatory statements on your credit report?
Yes
No
Thank you for taking the time to fill out this survey. If you need to contact us - email us at sbdc@tcnj.edu or check out our website: www.tcnj.edu/sbdc