Private Bank Private Equity Lender Public Bank Angel Investor Hard

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					                                                                                           FBS Corp: Form IIS

                                          Investor Interview Sheet
Part 1:

Company Name:______________________________________________________________________


Address:_____________________________________________________________________________


Email:____________________________________________ Phone:_____________________________

         Is this a: (Please check one)
              □ Private Bank
              □ Private Equity Lender
              □ Public Bank
              □ Angel Investor
              □ Hard Money Lender
              □ Affiliate Intermediary
         Can this entity checked above produce referrals? (Please check all that apply)
              □ Client Referrals
              □ Credibility from Financials
              □ Products or Services Provided
              □ Proven History
              □ Type of Guaranty
         Are there any costs for placing an application? ___________________________

         Are there costs associated with being involved in the program itself? ______________________

                 If so, can you provide a breakdown of funds?___________________________________




                                              (Continue onto Part 2)

Confidential Information Authorized Parties Only                                     Last Revised 10/22/2009
                                                                                            FBS Corp: Form IIS

Part 2:
Qualifying agents for project acceptance:
       Required Principal Experience?_____________________________________
       Preferable amount of members on the Board of Directors?_____________________________
                Do all board members need experience in this field?___________________________
       What type of business plan is accepted? (Please check all that apply)
             □ Principal Party Written
             □ Third Party Experienced Designer
             □ ASA Certification
       How many years required on the projected pro-forma?_________________________________
       Does the Investor look at personal credit score?______________________________________
                If so, what is the minimum required score?____________________________________
       Are the preferable types of projects for the Investor/Investor group: (Please check all that apply)

             □ Humanitarian
             □ Green Energy
             □ Real Estate
             □ Medical
             □ Technology
             □ Large Commercial
             □ Small Business
       What are the amounts that the Investor can loan out on their budget year?____________________
       Do you foresee an increase or decrease in the budget allocation for next year?________________
       How does the Investor hold collateral?

             □ Equity
             □ Recourse
             □ Joint Venture
             □ Asset Based


Confidential Information Authorized Parties Only                                     Last Revised 10/22/2009

				
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