Has your business been established yet?
                  
               
              
                  What's the purpose of your business loan?
                      
    
                
                
        
        
                
        
        Please Select
                 
        
                
                         
                Business Debt Consolidation
                         
                Equipment Purchase
                         
                Payroll
                         
                Startup
                         
                Partnership Buyout
                         
                Business Acquisition
                         
                Business Expansion
                         
                BHG Loan Refinance
                         
                Partnership Buy-in
                         
                Working Capital
                         
                Other
                         
                Passive Investment
                         
                Real Estate Acquisition/Improvement, owner occupied
                         
                Real Estate Acquisition/Improvement, non-owner occupied
             Required 
                    
               
              
                  What's the purpose of your business loan?
                      
    
                
                
        
        
                
        
        Please Select
                 
        
                
                         
                Startup
                         
                Real Estate Acquisition/Improvement, owner occupied
                         
                Real Estate Acquisition/Improvement, non-owner occupied
                         
                Passive Investment
                         
                Business Acquisition
                         
                Partnership Buy-in
             Required 
                    
               
              
                  What selection best represents the business you are starting?
                      
    
                
                
        
        
                
        
        Please Select
                 
        
                
                         
                Accommodation and Food Services
                         
                Administrative and Support and Waste Management and Remediation Services
                         
                Agriculture, Forestry, Fishing and Hunting
                         
                Arts, Entertainment, and Recreation
                         
                Construction
                         
                Educational Services
                         
                Finance and Insurance
                         
                Health Care and Social Assistance
                         
                Information
                         
                Management of Companies and Enterprises
                         
                Manufacturing
                         
                Mining
                         
                Professional, Scientific, and Technical Services
                         
                Public Administration
                         
                Real Estate Rental and Leasing
                         
                Retail Trade
                         
                Transportation and Warehousing
                         
                Utilities
                         
                Wholesale Trade
                         
                Other Services (except Public Administration)
             Required 
                    
               
              
                Can you provide more information?
                    
    
                
                
        
        
                
        
        How will you use your funds?
                 
                    
                
                         
                Credit Card/Debt Consolidation
                         
                Home Improvement
                         
                Major Purchase
                         
                Other
                         
                BHG Loan Refinance
                         
                Life Event
              
                    
                    Required 
                    
               
           
          
              
              
              
              
              
              
                  
    
                
                
        
        
                
        
        Phone Type
                 
        
                
                         
                Mobile
                         
                Home
                         
                Office
             Required 
                    
 
              
              
                  
    
                
                
        
        
                
        
        State
                 
        
                
                         
                Alabama
                         
                Alaska
                         
                Arizona
                         
                Arkansas
                         
                California
                         
                Colorado
                         
                Connecticut
                         
                Delaware
                         
                District Of Columbia
                         
                Florida
                         
                Georgia
                         
                Hawaii
                         
                Idaho
                         
                Illinois
                         
                Indiana
                         
                Iowa
                         
                Kansas
                         
                Kentucky
                         
                Louisiana
                         
                Maine
                         
                Maryland
                         
                Massachusetts
                         
                Michigan
                         
                Minnesota
                         
                Mississippi
                         
                Missouri
                         
                Montana
                         
                Nebraska
                         
                Nevada
                         
                New Hampshire
                         
                New Jersey
                         
                New Mexico
                         
                New York
                         
                North Carolina
                         
                Ohio
                         
                Oklahoma
                         
                Oregon
                         
                Pennsylvania
                         
                Rhode Island
                         
                South Carolina
                         
                South Dakota
                         
                Tennessee
                         
                Texas
                         
                Utah
                         
                Vermont
                         
                Virginia
                         
                Washington
                         
                West Virginia
                         
                Wisconsin
                         
                Wyoming
             
 
              
           
          
              
              
              
                  Alimony, child support or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.
               
              
                      
    
                
                
        
        
                
        
        Where does your credit score fall?
                 
        
                
                         
                720 - 850
                         
                680 - 719
                         
                640 - 679
                         
                0 - 639
             Required 
                    
               
                  
    
                
                
        
        
                
        
        Current Occupation
                 
        
                
                         
                Accountant
                         
                Acupuncturist
                         
                Advanced Practicing RN
                         
                Advanced Registered NP
                         
                Architect
                         
                Attorney
                         
                Certified Registered Nurse Anesthetist
                         
                Chiropractor
                         
                Dental Hygienist
                         
                Dentist
                         
                Doctor of Physical Therapy
                         
                Engineer
                         
                Financial Advisor
                         
                Insurance Agent
                         
                Licensed Practical Nurse (LPN)
                         
                Naturopathic
                         
                Nurse Practitioner
                         
                Occupational Therapist
                         
                Optometrist
                         
                Osteopath
                         
                Pharmacist
                         
                Physical Therapist
                         
                Physician Assistant
                         
                Physician/Surgeon
                         
                Pilot
                         
                Podiatrist
                         
                Professor
                         
                Psychologist
                         
                Real Estate Broker
                         
                Registered Nurse
                         
                Speech-Language Pathologist
                         
                Stock Broker
                         
                Veterinarian
                         
                Other Healthcare
                         
                Other
             Required 
                    
 
                  
    
                
                
        
        
                
        
        Primary Income Source
                 
        
                
                         
                Salaried
                         
                Contracted
                         
                Full Ownership in Business
                         
                Partial Ownership in Business
             Required 
                    
 
                  
    
                
                
        
        
                
        
        Secondary Income Source
                 
        
                
                         
                No Secondary Source of Income
                         
                Salaried
                         
                Contracted
                         
                Full Ownership in Business
                         
                Partial Ownership in Business
             Required 
                    
 
                  
    
                
                
                    
        
                
        
        Did you receive W2's from more than 1 employer last tax season?
                 
                
    
                    
                    Required 
                      
              
              
              
              
                  
                      No Cost or Commitment
                      
                          We know that our clients are serious about their credit score, which is why we will not conduct a hard inquiry when you apply. So exploring your financing options will not impact your credit score.
                      
                   
               
           
          
              
              
              
              
                      
    
                
                
        
        
                
        
        State
                 
        
                
                         
                Alabama
                         
                Alaska
                         
                Arizona
                         
                Arkansas
                         
                California
                         
                Colorado
                         
                Connecticut
                         
                Delaware
                         
                District Of Columbia
                         
                Florida
                         
                Georgia
                         
                Hawaii
                         
                Idaho
                         
                Illinois
                         
                Indiana
                         
                Iowa
                         
                Kansas
                         
                Kentucky
                         
                Louisiana
                         
                Maine
                         
                Maryland
                         
                Massachusetts
                         
                Michigan
                         
                Minnesota
                         
                Mississippi
                         
                Missouri
                         
                Montana
                         
                Nebraska
                         
                New Hampshire
                         
                New Jersey
                         
                New Mexico
                         
                New York
                         
                North Carolina
                         
                Ohio
                         
                Oklahoma
                         
                Oregon
                         
                Pennsylvania
                         
                Rhode Island
                         
                South Carolina
                         
                South Dakota
                         
                Tennessee
                         
                Texas
                         
                Utah
                         
                Vermont
                         
                Virginia
                         
                Washington
                         
                West Virginia
                         
                Wisconsin
                         
                Wyoming
             Required 
                    
               
              
              
                      
    
                
                
        
        
                
        
        Business Structure
                 
        
                
                         
                Corporation
                         
                Sole Proprietorship
                         
                Professional Corporation (PC)
                         
                Professional Association (PA)
                         
                S Corporation
                         
                Limited Liability Corporation (LLC)
                         
                Professional LLC
                         
                Partnership
                         
                Professional Services
                         
                Limited Company (LTD)
                         
                Limited Liability Partnership (LLP)
                         
                Non-Profit
             Required 
                    
               
              
                      
    
                
                
        
        
                
        
        Business title
                 
        
                
                         
                Additional Guarantor
                         
                CEO
                         
                Director
                         
                Managing Partner
                         
                Managing Member
                         
                Owner
                         
                Partner
                         
                President
                         
                Secretary
                         
                Treasurer
                         
                Vice President
                         
                Other
             Required 
                    
               
              
              
              
                      
    
                
                
        
        
                
        
        Ownership %
                 
        
                
                         
                5%
                         
                10%
                         
                15%
                         
                20%
                         
                25%
                         
                30%
                         
                35%
                         
                40%
                         
                45%
                         
                50%
                         
                55%
                         
                60%
                         
                65%
                         
                70%
                         
                75%
                         
                80%
                         
                85%
                         
                90%
                         
                95%
                         
                100%
             Required 
                    
               
           
          
              
              
              
    
    
    By checking accept on this loan application I hereby authorize the release of all credit information, including loans, leases, checking, savings, trade references and personal credit history, pertaining to the company, its principles, and the people listed below to Bankers Healthcare Group LLC dba BHG Financial and/or its designees or assignees. I confirm that all information provided for this BHG Loan Application is complete and accurate. I agree to BHG Financial contacting me via email, phone, and text to provide transactional notifications in regards to my application or loan. Such authorization shall extend to subsequent updates for credit and collection purposes. I consent to the verification of my income and employment through a credit bureau.