First Name:
Last Name:
Company:
Address:
City:
State/Province:
Zip:
Country:
To which region this country belongs:
--None-- Select USA Canada Japan Europe Singapore Hongkong China India South America Mexico Rest of Asia Middle East Africa Other
Phone:
Cell Phone:
Fax:
Month and Year Business License taken:
Email:
Re-enter Email:
Website:
Company Legal Status:
--None-- Proprietorship Partnership LLC or Pvt. Ltd. Corporation Other
Est Net Worth of Proposers:
--None-- upto $50000 upto $100000 upto $250000 upto $500000 upto $1Mn upto $2.5Mn $2.5Mn +
Available Cash Liquid Amount:
--None-- upto $20000 $21000 - $50000 $51000 - $100000 $101000 - $200000 $251000-$500000 $501000 - $1 mn $1.1 mn+
Proposer's Equity in the Project:
--None-- $2.6 mn + $1.1mn up to $2.5mn $501000 up to $1mn $251000 up to $500000 $101000 up to $250000 $26000 up to $100000 $25000 or less
Project Description:
Project Legal Name:
Total Project Cost:
--None-- More than $10mn $5.1mn up to $10mn $1.1mn up to $5mn $501000 up to $1mn $251000 up to $500000 $101000 up to $250000 $100000 or less
Use of Funds:
Loan Investment Terms No of years:
--None-- Not Applicable upto 12 months upto 5 years upto 10 years upto 15 years upto 30 years
Time frame to organize funds
--None-- up to 30 days up to 60 days up to 90 days up to 180 days Flexible
Primary Security Offered:
--None-- All Project Assets+100% or more Cash Deposit+Personal Guarantee All Project Assets+50% to 100% Cash Deposit+Personal Guarantee 100% Bank Guarantee All Project Assets+Personal Guarantee+Collateral All Project Assets+Additional Collateral All Project Assets+Personal Guarantee All Project Assets
Bank or Third Party Guarantee Available:
--None-- available More than $5mn available More than $1mn available $501000 up to $1mn available $251000 up to $500000 available up to $250000 Nil but to be organized
Additional Collateral Offered :
--None-- available More than $5mn available $1.1mn up to $5mn available $501000 up to $1mn available $251000 up to $500000 available $101000 up to 250000 Nil but to be organized Nil
How committed are you to this project?:
Cash amount invested in this project:
--None-- $2.6 mn + $1.1mn up to $2.5mn $501000 up to $1mn $101000 up to $500000 $51000 up to $100000 $1000 up to $50000 Nil
Willing to pay CMG processing fees?:
--None-- Yes - $7,500 for Loans $2 mn to $5 mn Yes - $10,000 for Loans $5.1 mn to $10 mn Yes - $15,000 for Loans $10.1 mn to $25 mn Yes - $20,000+ for Loans $25.1 mn or more Not Sure No
Type of Project:
--None-- Current Project Refinancing Current Project Tight Cashflow Minor Expansion Major Expansion Leasing of Equipment Start up Project Organize letter of credit or other type of project Real Estate Purchase/Lease
Project Summary and profitability:
Amount of financing required:
Management Experience in Industry:
--None-- Less than one year or Nil 1 2 3 4 5 6 7 8 9 10 10 +
How would you rate your current financing efforts?:
--None-- Excellent Good Needs internally-driven improvement Needs External Assistance Needs improvement across the board Does not apply
Investment Grade Business Plan available?:
--None-- Yes No. To be prepared Project Profile available Personally prepared Business Plan Redo Business Plan available
Do you want CMG to create or reformat
--None-- Yes No Not Sure
Are you willing to pay upfront Business Plan Fees (Select one)?:
--None-- Yes - $10,000 for loans from $2 Million to $5 Million Yes - $15,000 for loans from $5.1 Million to $10 Million Yes - $20,000 for loans from $10.1 Million to $25 Million Yes - $25,000+ for loans from $25.1 Million or more Not Sure No
Short Term Objectives(Select all that apply-
--None-- Organize thoughts & define business model Obtain seed capital Obtain loan & working capital Improve performance & obtain necessary business capital Expansion financing Purchase/ lease Property Purchase/lease Equipment Purchase & finance business acquisition Define and finance specific business acquired & mprove performance Update & Re-do existing business plan
Project Stage:
--None-- Start-up Existing running profitable co Existing business Break-even Existing business incurring losses Acquisition of running Business Acquisition of closed Business Other
Revenue Last 12 Months:
--None-- NIL Up to $100.000 Less than $500,000 Less than $1 Million Less than $3 Million Less than $10 Million More than $10 Million
Profit before tax last 12 months:
--None-- Loss greater than $500,000 Loss greater than $50,000 Loss less than $50,000 Profit less than $50,000 Profit less than $250,000 Profit less than $500,000 Profit greater than $500,000
Please select the service you need:
--None-- Venture Capital Business Loan Equity Debt+Equity Guarantee/LC Lease Finance Line of Credit Business Plan Service Consulting for financing Business Plan to disbursement of funds Multiple Other
Executive Summary Available:
--None-- Available now Available within 30 days Will not provide
Expected use of funds:
--None-- Available now Available within 30 days Will not provide
Resumes of Management:
--None-- Available now Available within 30 days Will not provide
Projected Cash Flow:
--None-- Available now Available within 30 days Will not provide
Balance Sheet:
--None-- Available now Available within 30 days Will not provide
Detailed Marketing Plan:
--None-- Available now Available within 30 days Will not provide
Articles of Incorporation:
--None-- Available now Available within 30 days Will not provide
Personal Financials:
--None-- Available now Available within 30 days Will not provide
Two Business References:
--None-- Available now Available within 30 days Will not provide
Information for financing available?:
--None-- Yes No Not sure
Bank Name:
Bank Telephone:
Date Account setup :
Current Bank Balance :
--None-- Greater than $300000 $201000 up to $300000 $101000 up to $200000 $51000 up to $100000 $26000 up to $50000 $10000 up to $25000 Less than $10000
No. of months to revenue generation
--None-- In revenue for more than 12 months Already in revenue Will be in revenue in less than 1 month Will be in revenue in more than 1 month and less than 3 months Will be in revenue in more than 3 month and less than 6 months Will be in revenue in more than 6 month and less than 12 months Will be in revenue in I year or more
Products that will generate revenue:
Financial Advisor Broker Name:
Further Correspondence
--None-- Through Broker Directly with Client
--None-- High School Bachelor's Masters MBA Doctor PHD Other
Credit History of Principal:
--None-- Poor Fair Fair to Good Good Excellent
Credit History of Business:
--None-- Poor Fair Fair to Good Good Excellent
Past Current litigation - Give details:
Any Patents or technical tie up:
--None-- Yes No
If yes give details:
Do you Own or Rent? Select One:
--None-- Own an Apartment/Condo Rent an Apartment/Condo Own a House Rent a House
Comments:
