Prequalify Now
City, State, Zip
Home Phone
Cell Phone
Business Phone
Best time to call
Which Number
Email Address
Have you Chosen a Franchise?
If yes, name of Franchise
Part I. Personal Financial Statement (PFS)
Liabilities Assets
Total Credit Card Debt
Car Loans/Leases
Certificate of Deposit
Loans against investments / Insurance
Money Market Account
Student Loans
Mutual Funds
First Mortgage
Second Mortgage
Stock Options
Home Equity Line
Taxes Due
Treasury Bills
(if cashed in)
Investment Real Estate
(if cashed in)
401K or 403B
IRAs or Keogh
Value of Life Insurance
Value of Private Business
Other (Jewelry/ Furnishings)
Part II. Personal Income & Expense Analysis (PIE)
Source of Income Annually
Gross Salary - Principal $
Spouse $
Other Income $
Rental $
Interest $
Dividend $
Other $
Total Income:
EXPENSES All answers should be on an annual basis
Mortgage - Personal Residence (PITI) $
Rental Property (PITI) $
Alimony $
Automobile Loans $
Child Care $
Credit Card Expenses
(5% of credit balances)
Educational Expenses $
Income taxes
(based on highest amount of past 3 yrs)
Installment Loans $
(minimum 10% of total income)
Personal Expenses $
Property Taxes
(if not included in mortgage payment(s))
Rental Property Expenses $
(including telephone and cable)
Other Expenses $
Total Expenses:
Net Discretionary Income (Income minus Expenses)
Coverage Ratio (Income/Expenses)
Part III. Questionnaire
How is your personal credit?
Do you know what your credit score is?
Have you had a bankruptcy within the last 10 years?
How much credit card debt, if any, do you have? $
Current/latest occupation:
Current/latest job title:
Current/latest salary $
Would you still be retaining your current salary?
Do you own a home or other property?
How much equity is in your home? $
How much equity is in the other property? $
Do you have a second income?
Available cash to invest: $
Are all your taxes current (Business or Personal)?
Have you applied for an SBA Loan before?
Were you approved?
Do you owe any money for student loans?
Are you current with your payments?
Are you a US citizen?
Have you ever been charged with, arrested or convicted of any criminal offense other than a minor vehicle violation?
Have you ever owned a business or franchise before?
If yes, please explain:
Considering other family income and your cash reserves, what is the least amount of yearly income you will need to draw from your business during the first year?

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