Request a Quote for Business Financing and Insurance M&A

Name*

First Last

Current Company Name

Current Company Address

Street Address Address Line 2 City State ZIP Code

Phone Number

E-Mail Address*

Website URL

Corporate Structure Type

Your estimated revenue (annual commission and fees)

Type of insurance product(s) sold*

List of company owners and corresponding percentage ownership share

Borrower’s estimated credit score

Has the borrower ever had a bankruptcy, short sale or tax lien?

Yes
No

Loan Amount Requested*

Will tax returns, P&Ls and Balance Sheets be available for both buyer and seller?

Buyer YES
Seller YES
Buyer NO
Seller NO

Have you already applied for a loan for this project?

Yes
No

If yes, with whom?

Are you part of SIAA or a cluster?

Yes
No

Loan Purpose

Please provide a short written overview of the project, including how the loan proceeds will be utilized. If it is a company purchase, size of revenue (commission) and expected purchase price.

Request a Quote

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