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

The pre-qualification questions must be answered upon filling out the financing application for eligibility purposes.

Name(Required)
Are you 18 years of age or older?(Required)
Is your business located in one of the following counties in Pennsylvania: Bedford, Blair, Cambria, Fulton, Huntingdon, Indiana, Somerset?(Required)
Are you a citizen of the US or have legal status?(Required)
Have you had a bankruptcy in the last 18 months?(Required)
Do you have any past due child support payments?(Required)
Is your business engaged in adult entertainment or on-line gambling?(Required)

Authorization

Everything I/we have stated in the pre-qualification is correct to the best of my/our knowledge.