Royalty FF & Associates | Funding Intake Form

Client Information

Tell us about you — let's get started right

Full Name *

Email Address *

Phone Number *

State of Residence *

Business Name (if applicable)

EIN (if applicable)

Business Entity Type

Funding Goals

What are you working toward? Be specific.

Desired Funding Amount *

Primary Purpose of Funding

Describe Your Goal (optional)

Internal Use Only

Pre-Qual Summary

Advisor assessment — not visible to client

Pre-Qualification Status

✦ Likely Credit Card Approval — No financials required ✦ Loan Candidate — Requires tax returns & bookkeeping ✦ Needs Credit Improvement Before Applying ✦ Refer to Banker / Platform Partner

Advisor Notes

Assigned Advisor

Intake Date