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FAQ

Financing Loan Inquiry Form

Please fill out this brief form so we get to know you and your business. A member of our Business Finance Team will contact you shortly.

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First Name *

Last Name *

Title:

Business Name *

DBA/Fictitious Name *

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Email *

Phone *

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State business incorporated in or plan to incorporate in: *

Annual Business Income: *

Does your business have more than 1 owner? *

Business Start Date *

NAICS Industry Code: *

How many employees do you currently have on your payroll? *

Business Address

Address Line 1 *

Address Line 2 *

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City *

Zip Code *

State *

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Gender

Male
Female

Race

Black or African American
American Indian or Alaska Native
Asian
Native Hawaiian or Other Pacific Islander
White

Veteran Status

Non-Veteran
Veteran
Service-Disabled Veteran

Do you consider yourself a person with a disability?

Yes
No

Ethnicity

Hispanic or Latino
Not Hispanic or Latino

Military Status

Non-Military
Member of Reserve or National Guard
Spouse of Military Member

Your business website

(www.YourBusinessName.com)

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What is the legal entity of your business?

Sole Proprietorship
C-Corporation
LLC
S-Corporation
Partnership
Other

What percentage of your business is female owned?

%

What percentage of your business is male owned?

%

Type of business

Professional Scientific & Technical Services
Mining
Manufacturing
Real Estate & Rental & Leasing
Management of Companies & Enterprises
Utilities
Finance & Insurance
Health Care & Social Assistance
Agriculture
Forestry Fishing & Hunting, Information
Wholesale Trade
Accommodation & Food Services
Administrative & Support
Construction
Public Administration
Arts Entertainment & Recreation
Waste Management & Remediation Services
Retail Trade
Education Services
Transportation & Warehousing
Other Services (except Public Administration)

If you are approved for funding, how many new employees do you plan to hire? *

Loan amount needed *

Description of your business *

(up to 1,000 characters)

Purpose of Loan *

Purchase Equipment
Purchase a Business
Purchase a Franchise
Purchase Real Estate
Leasehold improvements
Purchase New Work Vehicle
Increase Product Manufacturing
Inventory/Supplies
Consolidate Business Debt
Working Capital

Comment:

(up to 200 characters)

Relationship to CBP *

Current CBP loan client
MDBA
Current Incubator Client
BFC Client/not loan affiliated
SBA referred
MEC/Mason SBDC Client
PWCEDA Client
FCEDA Client
Internet Search
Other

Do you need business development assistance? *

Select all areas of assistance that apply *

Startup Business support
Business development guidance
Business financial counseling
Business financial training
Credit counseling
Personal financial counseling
Business expansion guidance
Professional support including Legal, Accounting, Taxes
Other type of entrepreneurial assistance

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“As an incubator client, CBP helped me successfully start my cybersecurity and IT solutions firm, SecureTech360. I found the staff helpful, knowledgable, and encouraging. I recommend them highly!”

Quiana Gainey, CEO, SecureTech360 (EDWOSB, SDVOSB, SWAM)

6564 Loisdale Court, Ste. 600, Springfield, VA 22150
(703) 768-1440

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