AltCap Application Part I

Thank you for considering AltCap for your business financing needs. Application Part I is designed to collect information used in our prequalification process.

Contact Information

First Name

Last Name

Business Legal Name

Business Street

Business Street (Apt/Unit)

Business City

Business State

Business Zip Code

Business Email

Business Phone

Business Website

Personal Information

Birthdate

SSN

Street

Street (Apt/Unit)

City

State

Zip Code

Phone

Have you ever been convicted of a felony?

If yes, are you currently on parole or probation?

Business Ownership

What percent of the business do you own?

How Many Additional Business Owners or Legal Entities Own 20% or more of Ownership?

Co-Owner #1: Name

Co-Owner #1: E-Mail

Co-Owner #2: Name

Co-Owner #2: E-Mail

Co-Owner #3: Name

Co-Owner #3: E-Mail

Co-Owner #4: Name

Co-Owner #4: E-Mail

Loan Request Information

Amount Requested

Please enter a numeric response without characters. For example, $15,000 would be 15000.

Business Start Date

Please format as MM/DD/YYYY.

Industry

Description of Business

What will you use the funds for?

What can you offer as collateral? (Please select your top choice)

Do you currently have any business or personal secured loans? (i.e., SBA, EDA, EIDL, any other banks?)

Lending Bank Or Institution

If needed, do you have an additional guarantor willing to sign?

Have you been denied a loan by another financial institution in the last 90 days?

Reason for Denial?

Additional Comments (i.e., bankruptcy, tax liens, child support payment plans, etc.).

How did you hear about AltCap?

Please include the name of your source.

If offered the opportunity to apply, would you be willing to provide additional supporting documentation?

AltCap Market Email

Source Email

Income and Expense (Personal and Business)

What was the amount of personal revolving payments (total annual amount paid towards personal credit cards) in the last year (in USD)?

Please enter a numeric response without characters. For example, $15,000 would be 15000.

What was the amount of personal mortgage or rent payments (total annual amount paid towards personal mortgages / rent) in the last year (in USD)?

Please enter a numeric response without characters. For example, $15,000 would be 15000.

What was the amount of personal installment payments (total annual amount paid towards personal loans) in the last year (in USD)?

Please enter a numeric response without characters. For example, $15,000 would be 15000.

What was the amount of business revolving payments (total annual amount paid towards business credit cards and lines of credit) in your last taxable year (in USD)?

Please enter a numeric response without characters. For example, $15,000 would be 15000.

What was the amount of business installment payments (total annual amount paid towards business loans) in your last taxable year (in USD)?

Please enter a numeric response without characters. For example, $15,000 would be 15000.

What was the amount of business gross revenue in your last taxable year (in USD)?

Please enter a numeric response without characters. For example, $15,000 would be 15000.

Annual Income

Please enter a numeric response without characters. For example, $15,000 would be 15000.

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