PREQUALIFICATION FORM

Section 1 - Funding Information

How much money do you need? $10,000 - $29,999 $30,000 - $49,999 $50,000 - $74,999 $75,000 - $99,999 $100,000 - $249,999 $250,000 - $499,999 $500,000 - $1,000,000 More than $1,000,000

Whats the money for? Working Capital Debt Consolidation Purchase Equipment Purchase Inventory Business Acquisition Build Business Credit Other

What is your average revenue for the last 3 months? Less than $5,000 $5,000 - $9,999 $10,000 - $19,999 $20,000 - $29,999 $30,000 - $39,999 $40,000 - $49,999 $50,000 - $74,999 $75,000 - $99,999 $100,000 - $249,999 $250,000 - $500,000 More than $500,000

How much time are you in business? 1 Year or More New Business

Section 2 - Business Information

Business Name:

Provide your EIN

Provide your FICO score

Entity Type: Select Entity Type

State: Select State

Line of Business: Select Industry

Section 3 - Owner Information

First Name:

Last Name:

Email:

Phone:

Consent Disclosure

In submitting this form, I agree to my details being used for the purposes of assessing my eligibility for business funding. The information will only be accessed by necessary company personnel and authorized lending partners. I understand my data will be held securely and that I have the right to change or access my information. I authorize Main Street Finance Group LLC, to contact me in regards to my business funding options via phone, email and or WhatsApp. I understand that by submitting this form my credit score will not by effected.

After submitting this form, in order to expedite the application process, you will be require to comply with our financal compliance regulations to verify your identity. This means that you will be required submit a copy of your overnment-issued photo ID and 3 months bank statements for your business account. Additional information maybe required depending on the lender and or loan type. The minimum required documents maybe emailed to support@msfg.finance or submitted securely via our online form.

Submit