This document contains a preliminary information and KYC (Know Your Customer) form for a funding request. It requests basic contact and background information about the applicant, including the name of the main shareholder and borrower, management experience, length of time seeking capital for the current project, type of business, address, credit score, funding amount requested, repayment period, collateral available, purpose of funding, asset description if applicable, and historical and projected financial performance. The applicant must sign and attach financial statements and an asset/liability statement for the request to be considered.