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Estimated minimum income required for your current living expenses $ _____________
Have you ever owned a business? Yes No
If yes, what type? __________________________________
Have you ever sought financing for the above-mentioned business? Yes No
If so, what was the name of the Lender? ____________________________________________
Have you ever gone through bankruptcy or compromised a debt?
Yes No
If yes, please state the date and details: __________________________________________________________________________
_________________________________________________________________________
____________________________________________________________________________________________________________________________________________________
Are there any suits, judgements, tax deficiencies, or other claims pending or in prospect against you? Yes No
If yes, please state the details: ___________________________________________________________________________________________________________________________________________________
____________________________________________________________________
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