For new businesses

[Pages:1]Small Business Loan Questionnaire

Name:

Address:

Email:

Age:

Marital status:

Are you a permanent resident of Los Angeles?

How did you hear about JFLA?

Phone Number: Spouse's name: Yes No

For new businesses: Please describe your current or start-up business:

My business will be: Retail

Wholesale

Service

Manufacturing

Other:

Name of company:

Product or service your business provides:

Total net revenue for the last three months:

Number of full-time employees:

Number of part-time employees:

My business is:

Home-based

Office-based

If office-based, my monthly rent is:

Does your business have all the necessary California licenses to operate? Yes

No

Explain:

I am requesting an interest-free loan for: $

Can you provide proof of need for your loan? Yes

No

Explain:

I can repay the loan in 36 months:

Yes

No

I have two California co-signers with credit scores of 680+: Yes

No

My credit score is:

Other sources of funding (please list):

This business

Is my main source of income/livelihood Is not my main source of income/livelihood

Please mail completed Small Business Loan Questionnaire, the JFLA Business Plan Guidelines and the signed Dispute Resolution Agreement to:

Jewish Free Loan Association Business Loan Program 5429 Lindley Avenue Tarzana, CA 91356

Once your documents are reviewed you will be contacted by a JFLA Loan Analyst to determine the next steps in the process.

Jewish Free Loan Association ? 6505 Wilshire Blvd., Suite 715, Los Angeles, CA 90048 ? LA Office 323.761.8830 ? fax 323.761.8841 ? Valley Office 323.761.8844 ? info@ ?

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