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Retirement Biz Funding

CFT Loan Placement Assistance Form
What is Your First and Last Name (*)

Please let us know your name.
What is Your Email (*)

Please let us know your email address.

Do you CURRENTLY have a Corporation Sub-S, C-Corp or LLC (*)




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If you currently Do Not have a physical office or a virtual office, you may list your company at your Home Address. This will speed up the process of getting started. We prefer that you have a separate address for your business, because it keeps of the positive effect he has on lenders, but if you truly work from home, it is recommended that you use your home address. Would you like to list your company using your home address?

Physical Address



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What is your home address: Street Address: City: State: Zip: (*)

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We will need to contact you to get started with your first business loan application and program. What is your best contact phone number: (*)

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Check here if you cell phone number is the same number as above. (*)



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Is the best contact number also your business phone number? yes no – my “business/phone number” is: (*)



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Have you ever had a sole proporitorship which is a DBA before? (*)




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Have you ever owned or been the president or officer of another corporation or LLC? (*)




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Did any sole propprietorship have any business credit cards, any corporate credit, store credit such as Staples? (*)




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Did any sole proprietorship have any business credit that was paid late or defaulted on credit payments? (*)





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Did any corporation or LLC have any business credit such as Staples or business credit cards? (*)





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If any corporation or LLC you were connected with have any late payments or defaulted accounts?






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You do not have to pay today. No matter which payment plan you choose. You can start getting credit and coaching immediately. Select the payment plan that best fits your budget. (*)






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Choose Your First Payment Date. The First Payment will be 4 weeks after the date you sign up and continue on the date you select every month thereafter. (*)




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Please enter your billing information as it appears on your credit card statement. Remember YOU WILL NOT BE BILLED the first payment until the date you selected.

First Name as it appears on your credit card (*)

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Last Name (*)

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Select the credit card type you want to use (*)





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Enter your Credit Card Number (*)

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Expiration Date (MM/YYYY) (*)

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Verification Number (this is a 3 digit number on the back of your card) (*)

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Select a payment amount from the menu (*)






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Select the date of your first payment (*)




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Enter Your Billing address that appears on your credit card statement

Address 1 (*)

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Address 2

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City (*)

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State (*)

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United States Only (*)

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Zip Code (*)

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Please enter the code
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