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Primary Point Of Contact
First Name
Last Name
Title
Email
Phone
Is This The Business Owner?
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Yes
No
Is This The Training Contact?
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Yes
No
Own 51% Or More Of The Business?
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Yes
No
Do Not Know
LendingPoint Requires A 2nd Owner If Owner Owns Less Than 51%. Would You Like To Enter In Another Owner Now?
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Yes
No
Is There Another Business Owner You Would Like To Include?
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Yes
No
Owner #2 Information
Salutation
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Mr.
Ms.
Mrs.
Dr.
Prof.
Owner Last Name
Owner First Name
Owner Title
Owner Email
Owner Phone
Does This Owner Own 51% Or More Of The Business?
Please select...
Yes
No
Do Not Know
Is This Owner The Training Contact?
Please select...
Yes
No
Basic Business Information
Doing Business As
Legal Business Name
Website
Annual Sales Revenue
Average Transaction Amount
Years in Business
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Less than 1
1
2
3
4
5
More than 5
Industry
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Automotive Repair
Consumer Goods
Education
Funeral Services
Home Improvement
Legal
Medical Devices
Medical Services
Other
Pets
Powersports
Vocational Training
Primary Offering Within Consumer Goods
Please select...
Appliances
Bicycles
Campers & Trailers
Camping Equipment
Car Stereo & Alarm
Electronics
Exercise Equipment
Furniture & Mattress
Home Entertainment Systems
Home Security Systems
Jewelry
Kids Playground Equipment
Musical Instruments
Other Product Over $1000
Outdoor Survival Gear
Portable Spas & Hot Tubs
Rims & Tires
Sporting Goods
Water Treatment Systems
Secondary Offering Within Consumer Goods
Please select...
Appliances
Bicycles
Campers & Trailers
Camping Equipment
Car Stereo & Alarm
Electronics
Exercise Equipment
Furniture & Mattress
Home Entertainment Systems
Home Security Systems
Jewelry
Kids Playground Equipment
Musical Instruments
Other Product Over $1000
Outdoor Survival Gear
Portable Spas & Hot Tubs
Rims & Tires
Sporting Goods
Water Treatment Systems
Primary Offering Within Powersports
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ATV
Dirt Bikes
Golf Carts
Jet Skis / Wave Runners
Other
Scooter & Moped
Segways
Snowmobiles
Secondary Offering Within Powersports
Please select...
ATV
Dirt Bikes
Golf Carts
Jet Skis / Wave Runners
Other
Scooter & Moped
Segways
Snowmobiles
Primary Offering Within Home Improvement
Please select...
Artificual Turf
Bath Remodel
Baths & Showers
Blinds / Window Treatments
Cabinets/Countertops
Chimney Repair
Decks
Doors
Flooring & Tile
Foundation Repair
Garage Doors
General Remodel
Generators
Gutters
Home Entertainment Systems
Home Security Systems
HVAC
In-Ground Pools
Kitchen Remodel
Landscaping
Other
Painting
Plumbing
Portable Spas & Hot Tubs
Roofing
Sheds & Gazebos
Siding
Solar
Walkways
Water Heaters
Water Treatment Systems
Wells
Windows
Wood Chippers, Sawmills & Splitters
Secondary Offering Within Home Improvement
Please select...
Artificual Turf
Bath Remodel
Baths & Showers
Blinds / Window Treatments
Cabinets/Countertops
Chimney Repair
Decks
Doors
Flooring & Tile
Foundation Repair
Garage Doors
General Remodel
Generators
Gutters
Home Entertainment Systems
Home Security Systems
HVAC
In-Ground Pools
Kitchen Remodel
Landscaping
Other
Painting
Plumbing
Portable Spas & Hot Tubs
Roofing
Sheds & Gazebos
Siding
Solar
Walkways
Water Heaters
Water Treatment Systems
Wells
Windows
Wood Chippers, Sawmills & Splitters
Primary Offering Within Medical Services
Please select...
Bariatric Surgery
Chiropractic
Cosmetic Dentistry
Cosmetic Surgery
Dermatology
ED Treatments
Fertility
General Dentistry
Hair Restoration
Laser Hair Removal
LASIK
Med Spa Services
Orthodontics
Orthopedic
Out of Pocket Medical Deductibles
Permanent Makeup
Plastic Surgery
Podiatry
Stem Cell Therapy
Tattoo Removal
Veterinary
Secondary Offering Within Medical Services
Please select...
Bariatric Surgery
Chiropractic
Cosmetic Dentistry
Cosmetic Surgery
Dermatology
ED Treatments
Fertility
General Dentistry
Hair Restoration
Laser Hair Removal
LASIK
Med Spa Services
Orthodontics
Orthopedic
Out of Pocket Medical Deductibles
Permanent Makeup
Plastic Surgery
Podiatry
Stem Cell Therapy
Tattoo Removal
Veterinary
Primary Offering Within Medical Devices
Please select...
Chair Lifts
General Medical Devices
Hearing Aids
Medical Beds
Other
Powered Scooters
Powered Wheelchairs
Secondary Offering Within Medical Devices
Please select...
Chair Lifts
General Medical Devices
Hearing Aids
Medical Beds
Other
Powered Scooters
Powered Wheelchairs
Please Describe Your Industry & Service(s)
Financing Information
Do You Currently Offer Financing?
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Yes
No
Do You Advertise Financing To Your Customers Today?
Please select...
Yes
No
What Finance Companies Do You Partner With?
Estimated # of Finance Opportunities a Month
Briefly Describe The Products/Services That Will Be Financed
Is an ISO Submission
Please select...
Yes
No
Channel
Please select...
Direct
ISO
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