Unity Lender Financial Questionnaire

Step 1 of 10

Credit Check Consent(Required)

The purpose of this questionnaire is to determine your eligibility for a loan from Unity Lender LLC. The information within this form is necessary to evaluate your financial eligibility. Unity Lender LLC requires a credit check to evaluation and approve any loans. By checking the box below, you are expressly authorizing Unity Lender LLC to run a credit check. Please check one:

I consent to a credit check by Unity Lender LLC as part of my application for a loan.

I do not consent to a credit check by Unity Lender LLC as this time, but understand it is required for Unity Lender to finalize and approve any loan agreement.

Desired Loan Amount(Required)

Desired Loan Length (In Months)(Required)

APPLICANT INFORMATION

Please provide the following information regarding the Loan Applicant. Please answer N/A for any fields which are not applicable to you.

First Name(Required)

Last Name(Required)

Current Country of Residence(Required)

Country of Origin(Required)

Passport Number(Required)

Street Address(Required)

Address Line 2

City(Required)

State(Required)

If live outside of United States, choose CA and enter your state / province / region in next box.

Province / Region

ZIP / Postal Code(Required)

Country(Required)

Phone Number(Required)

Email(Required)

Date of Birth(Required)

Gender(Required)

This is required by our loan software.

CO-SIGNER OR GUARANTOR (OPTIONAL)

Please provide the information for the Co-Signer and/or Guarantor for your loan. The Unity Lender team will also subsequently require additional financial information of the Co-Signer or Guarantor to close on the loan.

Will you be adding a co-signer or guarantor to your loan application?(Required)

What is your relationship to the Co-signer or Guarantor?(Required)

Other (Please Specify)(Required)

First Name(Required)

Last Name(Required)

Street Address(Required)

Address Line 2

City(Required)

State(Required)

If live outside of United States, choose CA and enter your state / province / region in next box.

Province / Region

ZIP / Postal Code(Required)

Country(Required)

Email Address(Required)

Phone Number(Required)

BUSINESS OR EMPLOYMENT INFORMATION

Please provide the following information regarding your Business or Employment. Please answer N/A for any fields which are not applicable to you.

Occupation(Required)

Job Title(Required)

Current Employer(Required)

Years of Employment with Current Employer(Required)

Are you self-employed?(Required)

If Self Employed, Name of Business(Required)

Street Address(Required)

Address Line 2

City(Required)

State(Required)

If business is located outside of United States, choose CA and enter your state / province / region in next box.

Province / Region

ZIP / Postal Code(Required)

Country(Required)

Business - Phone Number(Required)

Business - Email(Required)

INVESTOR ELIGIBILITY QUESTIONNAIRE

Unity Lender requires all customers to be accredited investors as defined in Rule 501 of Regulation D. To invest in many alternative investment classes such as hedge funds, venture capital, or private equity, an individual must qualify as an accredited investor. Customers of Unity Lender LLC will be required to provide a letter evidencing Accredited Investor status from a Certified Public Accountant, Attorney or appropriately licensed professional before final approval of any Unity Lender LLC Loans. You only need to meet one of the status requirements below to qualify as an accredited investor.

Accredited Investor Status - Net Worth(Required)

I am an “accredited investor” as defined in Rule 501 of Regulation D under the Act because I have a net worth (or joint net worth with my spouse) in excess of US$1,000,000. For purposes of this question, “net worth” means the excess of total assets (excluding value of primary residence) over total liabilities. (Please Note: The estimated fair market value of the primary residence is not included as an asset and the amount of debt secured by the primary residence, up to the estimated fair market value of the property, is not included as a liability. However, the amount of any debt secured by the primary residence that is in excess of the estimated fair market value of the primary residence is included as a liability. In addition, if the amount of debt secured by the primary residence increased within the last 60 days (other than as a result of acquiring the residence), then the amount of the increase is included as a liability.)

Yes

Accredited Investor Status - Net Income(Required)

I am an “accredited investor” as defined in Rule 501 of Regulation D under the Act because I have had individual income in excess of US$200,000 (excluding my spouse) in each of the two most recent years (or joint income with my spouse in excess of US$300,000 in each of those years) and have a reasonable expectation of reaching the same income level in the current year.

Yes

Accredited Investor Status - Professional Certifications(Required)

I am an “accredited investor” as defined in Rule 501 of Regulation D under the Act because I hold one or more valid professional certifications, designations, or other credentials, which are active and that have been designated by the SEC, including the Series 7, Series 82, and Series 65 licenses, and any additional qualifying professional certifications, designations and credentials that may be designated by the SEC from time to time.

Yes

Unity Lender Financial Questionnaire

APPLICANT INFORMATION

CO-SIGNER OR GUARANTOR (OPTIONAL)

BUSINESS OR EMPLOYMENT INFORMATION

INVESTOR ELIGIBILITY QUESTIONNAIRE

FINANCIAL BACKGROUND

INCOME

EXPENSE

CO-SIGNER FINANCIALS

ASSETS

LIABILITIES

CREDIT HISTORY

IMMIGRATION ATTORNEY

BEHRING EB- 5 INFORMATION

UNDERSTANDING