Business Compliance Assessment

1. Business Owner Information

Date This is required

Primary business owner name This is required

Mobile phone Enter your phone number Enter a valid number like +1555-123-4567

Email address Enter an email Use an address with (@) and (.)

Preferred contact method This is required

Home city and state This is required

Additional owners and ownership percentages (if any) This is required

2. Business Information

Legal business name This is required

DBA (if applicable) This is required

Business address (street, city, state, ZIP) This is required

Business phone Enter your phone number Enter a valid number like +1555-123-4567

Business email Enter an email Use an address with (@) and (.)

Business website (if any) This is required

Business structure This is required

State of formation This is required

Date formed This is required

EIN status This is required

Years in business This is required

Months in business This is required

Industry This is required

Business activity description This is required

NAICS code (if known) This is required

Number of employees This is required

Business location type This is required

3. Funding Request

Funding amount range This is required

Exact amount requested (if known) This is required

Purpose of funding This is required

Funding timeline This is required

Type of funding you are considering This is required

Explain how the funds would be used This is required

4. Revenue & Business Performance

Does the business currently generate revenue? This is required

Approximate monthly gross revenue (if applicable) This is required

Approximate annual gross revenue (if applicable) This is required

Approximate monthly expenses (if applicable) This is required

Approximate monthly net income (if applicable) This is required

Revenue trend This is required

Highest and lowest revenue months (if known) This is required

Primary source of revenue This is required

Payment methods accepted This is required

5. Business Banking

Do you have a dedicated business checking account? This is required

Banking institution (if applicable) This is required

Approximate account age (if applicable) This is required

Approximate monthly deposits (if applicable) This is required

Approximate average daily balance (if applicable) This is required

Number of NSFs (non-sufficient funds) in the last 90 days This is required

Do personal funds get deposited into the business account, or vice versa? This is required

6. Financial Records & Documentation

Which of the following do you currently have available? This is required

Bookkeeping method This is required

Business tax return filing status This is required

Personal tax return filing status This is required

7. Business Credit Profile

Do you have a D-U-N-S number? This is required

Have you established commercial credit (business credit separate from personal)? This is required

Business credit profiles on file (Experian, Equifax, D&B) and approximate PAYDEX score if known This is required

Number of business tradelines (vendor accounts, business credit cards, etc.) This is required

Business credit cards held and approximate limits This is required

8. Personal Credit & Guarantor

Approximate personal credit score range This is required

Approximate personal credit utilization This is required

Late payments, collections, charge-offs, tax liens, bankruptcy, or foreclosure (general description only) This is required

If a bankruptcy was filed, approximate discharge date This is required

9. Existing Business Debt

Existing business debt (loans, lines of credit, merchant cash advances, credit cards, equipment financing, other) This is required

Approximate total business debt This is required

Approximate total monthly debt payments This is required

Is any current business debt past due? This is required

10. Previous Funding Applications

Have you applied for business funding in the last 12 months? This is required

If yes, how many applications? This is required

If yes, what was the outcome? This is required

If approved, approximate amount This is required

If declined, reason given (if known) This is required

11. Business Fundability & Compliance

Fundability and compliance checklist This is required

12. Government, Tax & Legal Issues

Do any of the following apply to your business? (select all that apply and describe) This is required

If any apply, please explain briefly This is required

13. Business Goals

What would you like capital to help you accomplish in the next 12 months? This is required

What is the biggest obstacle standing in the way right now? This is required

Revenue goal for the next 12 months This is required

14. Documents to Provide

Reminder: do not enter Social Security numbers, bank login credentials, account numbers, credit card numbers, tax return data, government ID numbers, or file uploads anywhere in this form.

We got it.

Thank you for completing your Business Compliance Assessment.
Urban AZ Financial staff will personally review your answers, calculate your 0-100 Business Compliance Score, and contact you to discuss next steps. We do not have a set response time, but we will be in touch.

I certify that the information provided in this Business Compliance Assessment is true and accurate to the best of my knowledge. I authorize Urban AZ Financial to contact me about this assessment and to use this information to prepare compliance recommendations. I understand that Urban AZ Financial is not a law firm, does not guarantee good-standing status, licensing approval, entity protection outcomes, or any specific legal or financial result, and that some matters may require review by a licensed attorney, CPA, or the applicable government agency. I understand this online form does not calculate an automated score, does not save partial progress, and does not make any professional determination by itself, staff will personally calculate my 0-100 Business Compliance Score and review all responses. I will not submit Social Security numbers, bank credentials, account numbers, credit card numbers, tax returns, government ID numbers, or documents through this form.

This is required

Urban AZ Financial provides business formation, administrative compliance, tax, bookkeeping, business-readiness, documentation, and consulting services within the scope permitted by applicable law. Urban AZ Financial is not acting as a law firm. Legal documents, legal opinions, complex Operating Agreement provisions, asset-protection advice, litigation matters, and transactions requiring individualized legal judgment should be prepared or reviewed by appropriately licensed counsel. Where appropriate, Urban AZ Financial may organize records, identify administrative issues, prepare supporting documentation, and assemble an attorney-ready review packet.

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Before You Begin

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Your Business Compliance Information

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Urban AZ Financial