Company

This field is for validation purposes and should be left unchanged.

By filling out this form, you are agreeing to be contacted by a Diamond Financial Services relationship manager.

First Name*

Last Name*

Email address*

Phone #*

Best way to contact you:*

Location:*

City State

Do you currently have ownership in other businesses?*

Yes

No

Were you referred to Diamond Financial?*

Yes

No

Referral name:

The following questions are about the use of loan proceeds and other information.

What will the loan proceeds be used for?*

Business Acquisition

Start-up

Refinancing

Business name:*

Industry:*

Business location:*

City State

Proposed ownership structure post-acquisition:*

Loan use description:*

Loan amount:*

How much can you put towards a down payment?*

Is real estate involved?*

Yes

No

Real estate amount:

Pre-Screen Application