Quick
Information Form
Note: Downloadable (DOC, PDF & TXT) versions of this
form can be found on our website: www.FDPcapital.com
If you are not
using a computer, please
Type or PRINT your answers using
block letters and please attempt to answer each question. (You may use “n/a”
for those questions that do not apply to you)
Today’s date: _____/_____/20____
1. Name of
Company (or individual) applying for funding, with COMPLETE mailing address. (Note: if you are a finder or
broker, please note your contact information in Block #17 below, as our
lenders/investors will want to talk to the principals for the project directly)
Legal Name of
Company:
Name of
Principal:
Business Address:
Phone:
Fax:
Cell:
E-mail:
Project Name:
Project
Website:
Location of
Project:
2. Company
owners and percentage of ownership. (5% or greater owners)
(Note that
short bios for key management personnel, must be included here. Complete
resumes/CV’s should be available and can be forwarded as separate documents)
3a. Type(s)
of funding you are looking for and why this type of funding (debt, equity,
private placement, etc.)?
3b. Have you tried to
obtain this funding, or possibly a Letter of Credit, from your own bank?
3c. Are you currently
working with any other potential funding sources, to obtain the funding you
need for your project?
3d. Do you need any special loan/investment terms? (Reserve interest, line of credit, financing of fees and/or points,
etc.)
4a. Brief description of the company.
4b. Number
of years in business.
4c. Type of
business entity. (DBA, GP, LP, LLC, Corp, etc.)
5. MII - Minimum Initial Investment: The amount of funding you are requesting? (Note: Ask for the full
amount that you need. Asking for too
little could be counter productive.)
6. LOI - Length of Investment: How long
will you need these funds?
7. ROI - Return on Investment: What do you
anticipate the total return on the investment will be?
8. What
forms of collateral will you be using? If
none, how do you propose to minimize the risk to our lenders/investors?
9a. How much of your own money do you currently have at risk in
association with this project and can you provide proof of these personally
invested funds? (Note: The reason this question is being asked, is that most
of our investors/lenders want to know how much "skin," you have in
your project. If you are not willing to put your own money into your own
project, why should they want to. Note that "sweat" equity will not
suffice as the only investment you have in your project.)
9b. How much money do you currently have that you can put into
your project, if you had to, for possible closing costs?
9c. Would you be willing
to pay travel expenses for an on site visit to meet face-to-face to look at and
discuss your project? (Note: The reason this question
is being asked is that we don’t want to waste your or our investor’s time. We need to make sure that we are working with
viable projects and with clients who are serious about meeting their project goals,
therefore we may need to visit your project site and meet with you in person.)
9d. How long have you been looking for funding for your
project?
10a. How
would you prefer to repay our lender/investor? (Please provide a proposed
repayment plan including any options here)
10b. Briefly describe
how our investors/lenders will benefit from funding your project.
11. If you
plan to use Real Estate as collateral, you MAY be asked to provide an appraisal
no more than 6 months old.
11a. What kind of real estate collateral
will you be using (if any)?
11b. Do you or your
company own commercial real estate?
11c. Own publicly traded
stock?
11d. Does
your company have authorized shares?
(If so, what percentage would be available for potential investors?)
11e. Have cash reserves?
11f. Have
monthly MasterCard and Visa Card, etc. merchant business coming in?
11g. Own your own equipment?
12. What is
your company's annual revenue? (Note: You MAY need to provide business or personal tax
returns to support revenue claims and list any third parties attached to your
project; or who will be due any payments or commissions.)
13. All
companies, even Fortune 1000 companies, typically pay a fee as part of the
funding process (see www.loanpricing.com). This fee may be called a due
diligence fee, application fee, retainer, etc. Do you understand that you may
be asked to pay a fee as a standard part of the lending process?
14. Do you
have a Business Plan and Financial Statement prepared for your project? (Note: We cannot process
a Funding Request without an up-to-date Executive Summary, Business Plan and
Financial Statement. The Financial Statement can be a separate attachment or
incorporated into the Business Plan. Either method is acceptable.)
15. Are
there any "skeletons in the closet" (bankruptcies - if discharged,
note date; foreclosures, criminal convictions, FTC or SEC fines or settlements,
pending civil litigation, etc.) that we need to be aware of prior to submitting
your Funding Request to our investors/lenders? (Note: An affirmative answer to this question
does NOT preclude your Funding Request from being submitted to our
investors/lenders; but PRIOR disclosure is a requirement.)
16. Additional Comments - Is there anything else
you feel we need to know that might help us to help you to obtain the funding
you need for your project? (Note: “None” is a valid answer.)
17a. Who is
your FDP Capital authorized Broker or Representative (if any)?
Rep. Name:
Address:
Phone:
Fax:
Cell:
E-mail:
Website:
17b. Number of broker points allotted to this broker (if any):
Note: Broker points are only allotted when you have a prior
agreement to pay a Broker or Finder representative for helping you obtain
financing. FDP Capital LLC does not
receive any portion of funds that you allot to Brokers or Finders as points.
When completed, you may print and fax this form to: Fax: 1- 215.252.5404
Or
You may save and e-mail* the completed form
to: funding@fdpcapital.com
*Please remember to include your “Project Name” in
the subject line of your e-mail
and attach any associated documents;
Executive Summary, etc.
Note: Downloadable (DOC, PDF & TXT) versions of this form can
be found on our website: www.FDPcapital.com .