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BUSINESS OWNERS
INVESTORS
NONPROFITS
FAQs
CONTACT US

InfusionSoft Test Page

TILT Forward – Business Owner Application

How much would you like to borrow? *

When do you need the money? *

How do you intend to use this funding?

Working Capital

Business Expansion

New Location

Equipment Purchase

Inventory or Merchandise Purchase

Capital / Facilities Improvements

Debt Refinancing

Insurance

Payables

Services (e.g. training)

Interested in coaching/mentoring

Business Owner’s First Name *
Business Owner’s Last Name *

Email of Business Owner *

Business Phone Number *

Owner Cell Phone Number *

Legal Name of your business *

Doing Business As Name *

Business Address *
Address Line 2
City *
State *
Zip *
Country *

Industry *

Is your business an for-profit or Non-profit enterprise?

Legal Entity Type *

Time in Business *

Still in the planning stagesLess than 1 year1 year or more but less than 2 years2 years or more but less than 5 years5 years or more

When did you start your business?

Business Tax ID (EIN):

Annual Business Revenues *

$0$1-$100,000 $100,001 – $250,000$250,001 – $500,000$500,001 – $1,000,000More than $1,000,000

Do you have a separate business bank account? *

NoYes

Does your business accept credit cards? *

NoYes

Annual Business Revenues

Average Monthly Business Bank Balance

What percent of the business do you own? *

Does your business have a merchant cash advance outstanding? *

NoYes

How would you characterize your credit history? *

ExcellentGoodFairPoorNo credit history

Do you have collateral to pledge for a loan? *

YesNoNot sure

Business Owner’s Home Address 1 *
City *
State *
Postal Code *

Business Owner’s Date of Birth *

Business Owner’s SSN (this allows us to verify your identity)

Race: *

Gender *

Veteran Status *

How did you hear about TILT Forward? *

Tell us your story.

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