Global Lending Form

Client / Project Name *

Broker Name *

First

Last

Broker Contact Information *

Email *

Project Location *

Address Line 1

Address Line 2

City

State

Zip Code

How much capital requested? *

Are the funds needed to start a business? *

Are funds needed to expand or refinance an already operating business? *

Are the funds needed to buy a business? *

Additional comments regarding your business:

Mike Petterson

Office Phone: (916) 520-4515

Email: info@clc-funding.com