Corporate Needs Analysis Existing Business/Corporation funding Questionaire Your Name (required) Your Email (required) Subject Your Message Corporate Needs Analysis – Existing Business/Corporation Date: _____________ Desired Loan Amount $_________________________ Name of owner(s):_____________________________________________________________________________ Business Name: _____________________________ Incorporated F Yes F No State_______ Year ________ Cell Phone #:(_______) __ __ __ ‐ __ __ __ __ Business/Home Phone #(_______) __ __ __ ‐ __ __ __ __ Fax # (______)__ __ __ ‐ __ __ __ __ Business Address: ______________________________________________________________________________ Best days & times to call: ________________________ Email Address:____________________________________ Business Description of Product/Service: ____________________________________________________________ Do you export your products and services? F Yes F No Would you be willing to do so? F Yes F No Are you currently employed outside of this business?:___________ If so, what do you do? _________________________________ Describe your passion and motivation for starting your business: _____________________________________________________________________________________________ _____________________________________________________________________________________________ I am going to ask you some financial qualifying questions to find out what way we can help you? What overall personal credit score? __________________ If they say, 700 + find out how do they know! Are you current on your home rent or mortgage? F Yes F No Are you current on your business rent or commercial mortgage? F Yes F No If you have a mortgage, is the interest rate adjustable/variable or fixed. (Circle one) Have you been late more than 30 days in the last 12 months/year? F Yes F No Have you ever declared bankruptcy? in the last 12 months? F Yes F No F Yes F No Have you had a foreclosure? in last 2 years? F Yes F No F Yes F No Are you delinquent on any loans such as credit card lines, auto or student loans? F Yes F No Do you have any other personal or business accounts, new or old, that are past due? F Yes F No Do you have any outstanding tax liens or legal judgments that are NOT in a payment plan? F Yes F No Can you provide a co‐signer outside of the business if required? F Yes F No Do you have an updated business plan available or strategy plan for your company? F Yes F No Would like assistance in creating one? F Yes F No How much have you invested in your business/project? ___________ How much do you NOW have available? ___________* Does your business involve any of the following: Real Estate investing ‐ MLM/network marketing ‐ adult entertainment? (If yes circle which one) F Yes F No Do you need expansion capital “right now” in order to expand your business? F Yes F No Unlocking the capital in your company! 2100 Southbridge Parkway, Suite 650 Birmingham, AL 35209 • Phone 205.823.9530• Fax: 800.809.5629• www.wallacecapitalfunding.com What three items is the financing for? (1) _____________ (2) _____________ (3) _______________ (Equipment, Real Estate, Refinancing, Business Purchase, Working Capital, Payroll, Expansion) Who do you currently Bank with? _____________________________________________________ Do you have large contracts or purchase orders and getting paid too slow? F Yes F No Who are your commercial customers? _____________________________________________________________ Can you provide supporting financial documents for your business right now? (ie. financials/ tax returns) F Yes F No Are you the sole owner or do you have partners? (Circle which one) If so, how many? ___________ Do you want to separate your business credit from your personal credit? F Yes F No What is your Dunn and Bradstreet number? _________What is your paydex score?_________ F Yes F No Is your business generating a profit, a loss, or breaking even currently? (Circle which one) How much is your gross monthly/yearly? ___________/____________* How much is your net profits monthly/yearly?__________/__________* Are you generating sufficient monthly profits from your business sales to support loan payments? F Yes F No If you were not running your business, what would you be doing (Write on back)? What is the exit strategy for your business venture (Write on back)? If you are forced to sell this business due to illness, family issues, relocation etc, would you like to get top dollars for your business? F Yes F No Do you have processes, systems and/or subsystems in place for your business so that your business is on autopilot? If so, what are they? ____________________________________________ F Yes F No Are you a Real Estate Investor? F Yes F No Are you a Construction Contractor or Developer? (If yes, Circle which one) F Yes F No Do you know anyone else that’s looking for business financing within the next 12 months? Please provide their name, telephone number and e‐mail address so that we may assist them as well. 1. _______________________________ ______________________ _______________________________ 2. _______________________________ ______________________ _______________________________ 3. _______________________________ ______________________ _______________________________ 4. _______________________________ ______________________ _______________________________ 5. _______________________________ ______________________ _______________________________ 6. _______________________________ ______________________ _______________________________ 7. _______________________________ ______________________ _______________________________ 8. _______________________________ ______________________ _______________________________ 9. _______________________________ ______________________ _______________________________ 10. _______________________________ ______________________ _______________________________ Unlocking the capital in your company! 2100 Southbridge Parkway, Suite 650 Birmingham, AL 35209 • Phone 205.823.9530• Fax: 800.809.5629• www.wallacecapitalfunding.com 69499