Loan Pre-Qualification Form In order to better assist you with lending options, please answer the following questions... Step 1 of 9 11% Name First Last PhoneEmail What State of the USA do you live in?AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificAre you a US Citizen or legal permanent resident of the US?YesNo Please select one that applies to youI am starting a new business OR looking to purchase a new franchise territoryI would like to purchase an existing business or acquire a franchise territory from a previous ownerI operate an existing business that needs working capitalWhat is the business you are starting or name of the franchise(s) you are considering?What is the business you hope to acquire?How long has the business been generating revenue?What is the average monthly revenue for the last 3 months?What percentage of the business do you or will you own?What loan amount are you looking for? What is your approximate credit score?Are you married?YesNoWhat is your spouse’s approximate credit score?Are you or your spouse a veteran of the US military?YesNoCan you provide a copy of the DD214?YesNoNot Sure Have you ever defaulted on a government-backed loan (VA, FHA, Student Loan, SBA loan)?YesNoHave you ever filed for personal bankruptcy?YesNoHow many years ago was it discharged?Have you ever foreclosed on a home?YesNoHow many years ago? Have you been arrested in the past year or do you have a prior felony on your record? (Please note, this does not necessarily disqualify your file. We need to be aware of what documentation will be required.)YesNoAre you involved in any pending litigation including divorce, auto accident, etc.?YesNoIf you do not pay off your credit cards each month, what is the approximate total balance due? What is your occupation?What is your annual salary?Do you plan to keep your employment while the business (if new start-up) is ramping up?YesNoIf you are married, what is your spouse’s occupation?What is your spouse’s annual salary?Will your spouse be keeping the employment while the business (if new start-up) is ramping up?YesNo What amount of liquid funds do you have in checking or savings accounts?What amount of funds do you have in a 401K or IRA?Would you like information about how to access funds in your retirement accounts without paying penalties?YesNoWhat amount of funds do you have in other investments (stocks/bonds/mutual funds)?Do you currently have a mortgage?YesNoWhat is the approximate balance due?What amount of equity do you have in the home?Did you have a mortgage or large loan in the past? What was the approximate loan amount?Do you have other real estate holdings?YesNo Have you registered a legal business name in your State yet?YesNoWhich have you registered (or which do you plan to register)LLCS CorporationC CorporationDoes your business (or will your business if new) accept credit or debit card payments from customers/clients?YesNoWould you like information about our merchant services equipment and packages?YesNoWould you like information about any of our other business services? (check all that apply) Business checks Printed materials (business cards, brochures, stationary, post cards) Large format print materials (signs, banners, trade show displays) Branded Clothing (embroidered or screen printed) Promotional Items and/or gifts Web Design/Hosting/Domain registration or renewal Email services at your domain Logo Design or Branding Advertisement design for publications Who referred you to Key Commercial Capital?Are you working with a franchise consultant or business broker?CAPTCHANameThis field is for validation purposes and should be left unchanged.