NO-OBLIGATION LOAN APPLICATION

NO-OBLIGATION LOAN APPLICATION

PLEASE FILL IN THE SHORT FORM PRE-APPLICATION BELOW, WHEN FINISHED CLICK THE SUBMIT BUTTON. All information provided by you will be kept strictly confidential.

Principal's Name:
Title:
Company Name:
Street Address:
City:
State:
Zip:
Telephone:
Cellular Phone:
Fax:
E-mail Address:

Select Each That Is Applicable Or Type in Request Information
Start-up Business
Existing Business
Years in Business:
Sole Proprietorship
Partnership
Corporation
Industry:
Amount of Financing Requested:
Purpose of Financing:
Franchise Purchase
Equipment Financing
Start-up Financing
Working Capital
Receivables Financing
Factoring
Other

Briefly Describe Purpose of Financing:
Personal Guarantees Available:	Yes No
Credit History of Company:	Excellent Satisfactory Poor
If a Business Purchase, Cash Invested By Buyer
Approximate Total Business Assets
Approximate Total Business Liabilities
Approximate Total Business Net Worth
Company's Annual Revenue
Company's Annual Net Profit

Smith Capital And Finance
37875 W 12 Mile Rd Suite 203
Farmington Hills , MI 48331

Phone:    (248) 553-7000
Fax:          (248) 553-7060
Email:     financing@smithcapitalandfinance.com
WebSite: www.smithcapitalandfinance.com