MWBE Enterprise Loan Fund Interest Form

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Please correct the field(s) marked in red below:

Name
 *
Business Name
 *
Telephone Number
 *
Email Address
 *

QUESTIONS

Please answer the questions below to help determine if your business qualifies for this loan strategy.

1. What date was your business started?
 *
2. What is the legal structure of your business?
2. What is the legal structure of your business?
3. Have you completed the proper filings to establish your business with the North Carolina Secretary of State’s office or the Pitt County Register of Deeds office?
3. Have you completed the proper filings to establish your business with the North Carolina Secretary of State’s office or the Pitt County Register of Deeds office?
4. Based on your most recently filed annual federal tax return, what were the gross receipts of your business?
 *
5. What is your home address?
 *
6. What is your business address?
 *
7. Have you applied for a loan from another lender?
7. Have you applied for a loan from another lender?
What was the result of your application?
8.  Are you a citizen to the United States?
8. Are you a citizen to the United States?
9. If you are a new business, have you completed the MWBE Business Skills Boot Camp or were you referred by the SBTDC or other counseling agencies?
 *
10. Have you completed a business plan for your business?
10. Have you completed a business plan for your business?
11. Do you have any delinquent local, state or federal taxes?
11. Do you have any delinquent local, state or federal taxes?
12. Describe your business including a brief history and the products and/or service(s) your business provides?
 *
13. Explain why you want to participate in this loan program and how it will help your business grow.
 *

You will be contacted to let you know how to proceed.

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