Coffman Capital Loan Inquiry Form Coffman Capital Loan Inquiry Form Please fill out and submit this form and we will contact you. Borrower #1(Required) First Last Designation (if any)For example : CPA, MD, DDS, DCBorrower #2 First Last Designation (if any)For example : CPA, MD, DDS, DCBusiness Location - US only(Required) City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Current Residence(Required) City State/Province Contact Phone(Required)Email Address(Required) Enter Email Confirm Email How did you hear about us?Briefly describe how you found us? Best time to call including Time Zone*:*We’re Eastern Time and you’re invited to call 813-891-1811 ext 101 at your convenience and voicemails appreciated if not available. We try to return calls in a timely manner.Citizenship(Required) US Citizen Permanent Resident *US Visa holder or foreign national *Loans require US Citizen or Permanent Resident. If in process, we can work with it as a loan closing contingency.Coffman Capital Loan RequestPLEASE HELP WITH THE FOLLOWING:Practice and/or Real Estate Acquisition Practice Acquisition Loan – Business-only (rented or home office) Practice Acquisition Loan – including Business Real Estate Business Real Estate Acquisition Loan Start-Up Financing Business Start-Up Loan – Business-only (rented or home office) Business Start-Up Loan – including Business Real Estate Debt Refinance Refinance of Business Loan, no Real Estate involved Refinance of Business Loan with Real Estate (combined loan) Refinance of Business Real Estate Loan Existing Business Working Capital or Equipment Financing Professional TypeLicense/CertificationMonth/Year issuedBusiness Ownership/ManagementIf currently a business owner, how long, and if managing or working in the business to be acquired, when you startedProject Description & IssuesPlease briefly describe project goals and any credit or legal issues we should know before we speak.Thank you for your help getting to know you and we look forward to helping you with your project!- Coffman CapitalCAPTCHA
