Preview Form

Full Name *

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Last Name *

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Contacts to Discuss Financing *

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Company Name *

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Date Of Inc

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What States do they operate in? *

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DBA name *

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Describe the products or services you offer: *

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Do you have a refund policy? *

Yes

No

If Yes, please describe your refund policy:

Is the customer required to sign to agree to the refund policy? *

Yes

No

If Yes, please provide a copy of the signed agreement:

Lending Specialist? Who is the Agent on this Opportunity?

Phone Number

Average Ticket Size

Are you currently Offering Financing?

Yes

No

Financing over 30k a month?

Yes

No

Current Lenders

Most important Finance Request. Pick 3 most important *

"Soft Pull" Pre qualification without affecting credit Amount of Approval Approvals % of Approvals of Applicants Available Promotions - Same as Cash Customer Service of Lender - Lender Support Ease of Process Low Dealer Fee Merchant liability – Chargebacks Compliance Risk management Payment amount to Customer APR

Marketing Strategies Used *

Web Print SEO Social media

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Estimated Monthly Financing

Daily Financed Applications Rejected

Sales Process *

In Store Retail On Line Call Center In Home

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Type of Financing Needed *

First Look - Prime Second Look - Near Prime Third Look - Subprime No Credit Needed All of the Above

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What are you most interested in? *

Approvals Approval amounts Cost to me Rates to customers Ease of process

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Min Ticket

Max Ticket

Overview of Opportunity

Special Requests

Special Requests *

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Consumer Financing Evaluation Form

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