Debt Form - First Union Lending

Unique ID
Debt Consolidation Form
Cash Management & Consolidation Program
Provide information on all current unsecured debt obligations, including unsecured lines of credit.
Contact Info
Name*
First Name Last Name
Company Name*
Phone*
Email*
Add Loans
Lender Funding Date Loan Amount Payback Amount Current Balance Frequency Payment Status
Edit
Delete
There are no loans.
Maximum number of loans reached.
Please note: The "Add Loan" button allows you to add all current loans to the debt consolidation form.
Be sure not to click "Generate Document" until you have added all current loans and debt obligations.
Email
This field is for validation purposes and should be left unchanged.

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×
How much funding do you need?*
How soon do you need funding?*
Use of Funds?*
What is your monthly revenue?
What is your Annual revenue?

Business Name*
Business Entity Type*
Street*
City*
State*
Zip*
Business Phone*
Cell*
Tax ID / EIN*
Website
Industry Type*
Property*
Business Start Date*
Date Format: MM slash DD slash YYYY

Primary Owner Information
Primary Name*
First Last
Primary Email*

Primary Credit Score*
Primary SSN*
Primary DOB*
Date Format: MM slash DD slash YYYY

Primary Phone*
Primary Owner %*
Primary Street*
Primary City*
Primary State*
Primary Zip*
Second Owner Information
Secondary Name*
First Last
Secondary Email*

Secondary Credit Score*
Secondary SSN*
Secondary DOB*
Date Format: MM slash DD slash YYYY

Secondary Phone
Second Owner %
Secondary Owner Street*
Secondary Owner City*
Secondary Owner State*
Secondary Owner Zip*

Outstanding Loans*
Open Bankruptcies*
Judgements/Liens*
Accept Credit Cards?*
Landlord/Mortgage Co
Contact
Phone
Existing Loans/Balances
Funding Company 1
Balance 1
Funding Company 2
Balance 2
Funding Company 3
Balance 3
Funding Company 4
Balance 4
Cancel

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Lender*

Funding Date*
Date Format: MM slash DD slash YYYY

Loan Amount*
Payback Amount*
Current Balance*
Frequency*
Payment*
Status*
Number of Payments Made
Number of Payments Left

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