Vital Business Finance Consultants
NO-OBLIGATION LOAN / LEASE APPLICATION

The most important part is your contact information. Please ignore any field that you do not know how to fill or you do not like to fill. Once we get your contact information, we will contact you in 24 hours.

We will use this information to identify your financial needs. The information you provide will be subject to verification prior to loan funding.  All information provided by you will be kept strictly confidential until we have your permission to send it to lenders.

PRINCIPAL'S NAME: 

Title: 

Company name: 

Street Address: 

City / Town: 

State: 

Zip Code: 

Telephone Number:            Cellular Phone: 

Fax:      Email: 

Start-up        Existing Business          Years in Business: 

Sole Proprietorship       Partnership     Corporation 

Industry: 

Amount of Financing Requested: 

Purpose of Financing: 

                   Franchise Purpose        Equipment Financing       Start-up Financing 

                   Working Capital              Receivables Financing     Factoring  

                   Other: 

Please give a little more briefly descriptions about what to do with financing:

Personal Guarantees Available:     Yes         No 

Credit History of Owner:   Excellent          Satisfactory          Poor 

Credit History of Company:    Excellent       Satisfactory        Poor 

If a Business Purchase:    Purchase Price  $

Cash Invested by Buyer  $

Total Business Assets  $

Total Liabilities  $

Total Business Net Worth  $

Company's Annual Revenue  $

Company's Annual Profit  $

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