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FUNDING PRE-QUALIFICATION QUESTIONNAIRE

This questionnaire is used solely to assess potential funding options & does not constitute a loan offer, credit decision, or financial advice.

SECTION 1: CONTACT & IDENTITY

Full Legal Name (Required)

Social Security #(Required)

Birthday

Month

Day

Year

Email(Required)

Phone(Required)

Address on Your License

Are you applying as:

Individual (Personal Funding)

Business Owner (Business Funding)

Both

SECTION 2: FUNDING GOALS

What type of funding are you seeking?

Personal Credit-Based Funding

Business Loan

Business Line of Credit

Equipment / Vehicle Financing

Working Capital

Desired Funding Amount (range):

$5k–$25k 

$25k–$50k

$50k–$100k

$100k+

How soon do you need funding?

Immediately

7–14 days

30+ days

Primary purpose of funds:

Consolidation

Expansion

Operating Capital

Personal Liquidity

Other

SECTION 3: PERSONAL PROFILE (Required for All Applicants)

Monthly Revenue

Estimated Personal Credit Score

750+

700-749

650-699

600-649

Below 600

Are any of the following reporting on your credit profile?

Late payments (last 12 months) 

Collections

Charge-offs

Inquiries

Bankruptcy

None of the above

SECTION 4: PERSONAL FUNDING (If Applicable)

Are you currently employed?

W-2

1099

Self Employed

Other

Employers Name (Income Source)

Employers Address

Length of Employment

Total Monthly Personal Income (all sources)

Are you paid via Direct Deposit?

Yes

No

Do you have personal credit cards? If Yes List Them:

Do you have any currently active personal loans ? If Yes, provide the details:

SECTION 5: BUSINESS PROFILE (If Applicable)

Legal Business Name

Entity Type

LLC

Corp

S-Corp

Sole Prop

State of Formation

Date Business Started

Business EIN

Business Address

Industry / Business Activity

Your Ownership Percentage

Business Website

Business Email

Business Phone Number

SECTION 6: BUSINESS FINANCIALS

Primary Revenue Source

Services

Products

Contracts

Mixed

List All Business Bank Accounts & Length of Time Open

Average Monthly Business Deposits

Any NSF (non-sufficient funds) in the last 6 months?

0

1-2

3+

SECTION 7: REVENUE & CASH FLOW

Average Monthly Revenue (Last 3–6 Months):

Highest Monthly Revenue

Lowest Monthly Revenue (last 6 months)

Is Business Revenue Consistent or Seasonal?

Consistent

Seasonal

SECTION 8: EXISTING OBLIGATIONS

Do you currently have any of the following

Personal Loans

Business Laons

Credit Cards

Lines of Credit

Merchant Cash Advances

None

Approximate total monthly payments

Are any accounts currently past due?

Yes

No

SECTION 9: CREDIT & COMPLIANCE DISCLOSURES

Any open lawsuits, liens, or judgments? If Yes, Explain:

Any recent address, business, or ownership changes (last 6 months)? If Yes, Explain:

Is your business in a restricted industry?

Yes

No

SECTION 10 COLLATERAL (If Available)

Do you have any assets available to support funding?

Vehicle

Equipment

Real Estate

Accounts Receivable

None

SECTION 11: DOCUMENTS

Depending on the funding product and third-party lender requirements, some or all of the following documents may be requested during the funding review process. Submission of documents does not guarantee approval or funding.

Driver’s license (primary owner)(Required)

Articles of Organization / Incorporation

Operating Agreement

EIN Letter

Last 3-6 months Business Bank Statements

Business Lease (if applicable)

Existing Loan Statements

Tax Returns (if required by lender)

SECTION 12: AUTHORIZATION & ACKNOWLEDGMENT

I acknowledge that this information is accurate to the best of my knowledge.

I understand this is a pre-qualification review and not a loan offer or approval.

I authorize funding partners to review my information for potential funding options.

Signature(Required)

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PLATFORM LOGINS

I authorize CRS to review credit information using voluntarily provided access credentials. CRS & its representatives do not alter credit data, initiate disputes, or assume responsibility

for third-party platforms.

I acknowledge that I am voluntarily providing access credentials for review purposes only.

EXPERIAN LOGIN

Experian Username

Experian Password

Experian Security Question with Answer

Experian 4-Digit Pin

TRANSUNION LOGIN

Transunion Username

Transunion Password

EQUIFAX LOGIN

Equifax Username

Equifax Password

NAV LOGIN

Nav Username

Nav Password

EXPERIAN BUSINESS

Experian Business Username

Experian Business Password

185 State Route 36, Building A, Suite 210, West Long Branch, NJ 07764 | info@consumerreportsolutions.com

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