Pre-Screen Application 1 Borrower Information2 Loan Information3 Optional Information Borrower InformationBy filling out this form, you are agreeing to be contacted by a Diamond Financial Services relationship manager. First Name:Last Name:Email address: Phone #:Best way to contact you:Phone / MorningPhone / AfternoonEmail / MorningEmail / AfternoonLocation: City StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Do you currently have ownership in other businesses?YesNoWere you referred to Diamond Financial?YesNoReferral name: Loan InformationThe following questions are about the use of loan proceeds and other information.What will the loan proceeds be used for?Business acquisitionStart-upRefinancingBusiness name:Industry:Business location: City StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Proposed ownership structure post-acquisition:Loan use description:Loan amount:How much can you put towards a down payment?Is real estate involved?YesNoReal estate amount: Optional InformationThe following questions are optional, but can be very useful to evaluate whether you will qualify for an SBA loan. Please take a few minutes to fill out what you can.Have you applied for a loan recently?YesNoWith which bank and why?Do you have any unpaid taxes?YesNoDo you have a payment plan agreed to with the IRS?YesNoDo you have any student loans outstanding?YesNoAre you current with your payments?YesNoDo you own real estate?YesYes - Multiple PropertiesNoWhat is your estimated equity position in your real estate?Do you have own any other potential collateral?Are you a United States citizen?YesNoAre you a permanent resident?YesNoCAPTCHAEmailThis field is for validation purposes and should be left unchanged.
