THERE ARE NO UP FRONT FEES ASSOCIATED WITH THE PRE-QUALIFICATION IF YOU HAVE PAID YOUR REPRESENTATIVE FOR ANYTHING PLEASE DO NOT PROCEED AND CONTACT US IMMEDIATELY

First Name *

Last Name *

Email *

Phone *

WHO REFFERED YOU? *

your credit score above 680? *

yes

no

CREDIT UTILIZATION UNDER 40% *

YES

NO

ANY CHARGE OFFS OR BANKRUPTCIES? *

YES

NO

Date of birth *

Social Security/ITIN Number

Street Address *

City

State

Country

Postal code

How Long Ago was the E.I.N. created for your LLC/Corp/SoleProp? *

Less than 1 year ago

1-2 years ago

More Than 2 Years ago

I don't have an E.I.N.

*this is typically around the same time your LLC/Corp/SoleProp was formed

Your Personal Annual Income

This is your individual income. Not your Household income *

What Type Of Income *

Self Employed

Employee With Paystubs

SCREEN SHOT OF FICO SCORE FROM SMART CREDIT *

Smart Credit Login Info *

Acknowledgement and Consent

You understand that by clicking the "Submit For Review" button immediately following this notice, you certify that all of the information provided in this form is true and correct, and you are providing written instructions to this company under the Fair Credit Reporting Act authorizing this company to obtain information from your personal credit profile or other information from Experian and/or TransUnion and/or Equifax. You authorize this company to obtain such information solely to conduct a pre-qualification for credit. the review process can take up to 2 weeks (depending on your credit profile)*

I AGREE TO THE ABOVE ACKNOWLEDMENT AND CONSENT *

YES

I Consent to Receive SMS Notifications, Alerts & Occasional Marketing Communication from Cooks Financial. Message frequency varies. Message & data rates may apply. Text HELP to 866-514-6672 for assistance. You can reply STOP to unsubscribe at any time.

the review process can take up to 2 weeks (depending on your credit profile)*

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