BPQ Gravity Form BPQ form test "*" indicates required fields Δ Step 1 of 5 20% The purpose of this questionnaire is for the business plan writer to personalize your Business Plan. These questions were formulated per the needs and requirements of lenders and the SBA. (All questions must be answered, if it does not pertain to your project, please write N/A.)Guarantor Contact InformationPrincipal Contact* Select OneDr.MissMr.Mrs.Ms.Prof.Rev. Preferred Prefix First Name Last Name Mailing AddressStreet Address*Address Line 2City*State/Region*Select StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukonPostal Code*Country*United StatesCanadaEmail* Phone Number*Do you have a partner?* No Yes Partner Name Select OneDr.MissMr.Mrs.Ms.Mx.Prof.Rev. Preferred Prefix First Name Last Name Partner Street AddressPartner Address Line 2Partner CityPartner State/RegionSelect StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukonPartner Postal CodePartner CountryUnited StatesCanadaPartner Email Partner Phone NumberDo you have second partner? No Yes Second Partner Name Select OneDr.MissMr.Mrs.Ms.Mx.Prof.Rev. Preferred Prefix First Name Last Name Second Partner Street AddressSecond Partner Address Line 2Second Partner CitySecond Partner State/RegionSelect StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukonSecond Partner Postal CodeSecond Partner CountryUnited StatesCanadaSecond Partner Email Second Partner Phone Number New Company Structure1. What is the name of your corporate entity?*2. How will the company be structured?* LLC S-Corp C-Corp 3. What city and state are your company operate in?*4. Who will be the owners and what percentage ownership will they have? 1. Owner's name*1. Percentage ownership*2. Owner's name2. Percentage ownership3. Owner's name3. Percentage ownership4. Owner's name4. Percentage ownership5. Do you have a mission statement for your business?* No Yes If yes, please provide*6. How many franchised units are currently open with this brand?* About the Business Owner and Management Structure7. What positions will you hire for the business including expected salary/pay? Please enter up to 5 entries for positions will you hire for the business. If you will have more, you must fill out a supplemental sheetThis field is hidden when viewing the form7. What positions will you hire for the business including expected salary/pay? (list out each)*First PositionPosition/Title*Number of employees with this position*Annual Salary*Second PositionPosition/TitleNumber of employees with this positionAnnual SalaryThird PositionPosition/TitleNumber of employees with this positionAnnual SalaryFourth PositionPosition/TitleNumber of employees with this positionAnnual SalaryFifth PositionPosition/TitleNumber of employees with this positionAnnual Salary8. What will be the operating days and hours for your business?*9. How will the owners be involved in the day to day business?*The Business10. Does your business require a physical location, like a brick and mortar or retail space in order to operate?* No Yes 11. What is the address of the business? (Business address must be no further from 80 miles from your home)*Address Line 2City*State/Region*Select StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukonZip*Country*United StatesCanada12. What is the total square footage of the location?*13. What is the cost of rent or building/land purchase price?*Rent Type, of the cost of rent or building/land purchase price:Select OneMonthlyAnnualTriple net14. Are there any additional costs associated with your location? No Yes Lease deposit $, building $, or land $, select all that apply: Lease Deposit Building Land Additional Cost:*15a. What are the zip codes you will operate? (be sure to list all)*15b. What are the counties you will operate? (be sure to list all)*16. Who are your direct competitors in the area? List their name and address if known.*17. What sets you apart from those competitors?* Financial Questions (your franchisor can support with many of these questions)18. Did you pay a franchise fee? If so, how much?*19. If your business model is territory based, what is the total territory fee?*20. If you are purchasing a vehicle or asset, what is the cost?*21. If you are leasing a vehicle, what is the monthly payment?*22. What is the average price per ticket/item a customer will spend?*23. How many customers are you projecting a month?*This field is hidden when viewing the form24. What is the average cost of goods sold (%)?*24. What is the average cost of goods sold (%)?* Please enter up to 5 entries for Product/Services. If you will have more, you must fill out a supplemental sheetCost of Goods SoldFirst Good/UnitName of Good*Annual Quantity*Price*Revenue*Average Cost of Goods Sold %*Second Good/UnitName of GoodAnnual QuantityPriceRevenueAverage Cost of Goods Sold %Third Good/UnitName of GoodAnnual QuantityPriceRevenueAverage Cost of Goods Sold %Fourth Good/UnitName of GoodAnnual QuantityPriceRevenueAverage Cost of Goods Sold %Fifth Good/UnitName of GoodAnnual QuantityPriceRevenueAverage Cost of Goods Sold %This field is hidden when viewing the form25. What is the average gross revenue for franchised units ($)? For Commercial Real Estate or Acquisitions OnlyPlease add any additional costs such as:Lease depositBuildingLandTransfer feeEquipmentInventoryFurniture & FixturesWhat do you anticipate the full total project cost to be?*Consent* DisclaimerBy completing and submitting this questionnaire, the applicant acknowledges that all information provided will be used and relied upon for the development of their loan package, business plan, financial model, and other related documentation necessary to pursue financing. The accuracy and completeness of the information are the sole responsibility of the applicant. Any errors, omissions, or inaccuracies in the information provided may negatively impact the evaluation of the loan application. Benetrends Financial is not responsible for any adverse decisions, including loan denial, resulting from erroneous, misleading, or incomplete information submitted by the applicant. The applicant further agrees to review all documents thoroughly and notify Benetrends Financial SBA bank financing department of any inaccuracies prior to submission to lenders.Signature*Date Month Day Year
