Francisco Herrera

Financial Consultant

Illinois • California • Texas • Colorado

REAL Loan Application

CORE Fund Application

Application form

REAL Application

Step 1 of 15

Dollar amount to be placed(Required)

What is the source of your funds?(Required)

Enter the source of your funds below

Name(Required)

Use your individual name as shown on your personal income tax return.
If the funds are coming from an international account, please make it match the name on your account EXACTLY.
DO NOT USE A COMPANY NAME HERE!

First

Beneficiary(Required)

The combined allotted percentages for beneficiaries must add up to 100%.

Name of Beneficiary

Percentage allotted to Beneficiary

Will the funds be taken out using your name or your business/entity name?(Required)

Business/entity name(Required)

Are you a United States Citizen?(Required)

Hidden

Citizen VOID

Are your funds coming from a retirement account?(Required)

Such as 401k, Traditional, Roth, SEP, SDIRA, etc.

Hidden

Retirement VOID

Client to wire funds?(Required)

Wiring instructions will be sent via email immediately upon completion of the application. If you don't receive it, please check your spam/junk folder.

Client Date of Birth(Required)

Must be over 18 years of age to participate in this program

MM slash DD slash YYYY

Email(Required)

Contract, documents and renewal notices will be sent to this email.

Cell Phone Number(Required)

Address(Required)

Use your address as shown on your income tax return

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Underwriting

Underwriting(Required)

I certify that the source of funds I am providing for this loan has not come in part or in whole from any illegal or illegitimate source(s).(Required)

Consent 2(Required)

I certify that the source of funds I am providing comes from expendable income.(Required)

Consent 3(Required)

I certify that I have spoken with a Drive Planning team member to ensure this is a suitable option for me.(Required)

Consent 4(Required)

In the event that my loan is paid out later than the 3 month period specified in this contract, I understand that interest will be prorated accordingly.(Required)

Initial(Required)

Enter your initials to signify that you have read and agree with the information above.

Federal Tax Classification(Required)

Choose the appropriate option for your business.

Individual/sole proprietor or single-member LLC

Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership)

C Corporation

S Corporation

Partnership

Trust/Estate

Other (Such as Charitable LLC)

Choose the tax classification

Enter other classification

Social Security Number(Required)

For tax purposes the government requires us to gather this information. This is a secure connection. Your information is not saved on our site and is never shared with anyone.

Employer Identification Number(Required)

For tax purposes the government requires us to gather this information. This is a secure connection. Your information is not saved on our site and is never shared with anyone.

Signature(Required)

Phone

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

Application form

CORE Fund Application

Step 1 of 14

Dollar amount to be placed(Required)

What is the source of your funds?(Required)

Enter the source of your funds below

Distribution(Required)

Choose your preferred distribution period.

3 year investment paying 22% every year

3 year investment paying 10% every 6 months

1 year investment paying 14% at the end of term

Name(Required)

First

Are you married?(Required)

Spouse Name

Use your spouse's name as shown on your income tax return.

First

Beneficiary(Required)

The combined allotted percentages for beneficiaries must add up to 100%.

Name of Beneficiary

Percentage allotted to Beneficiary

Will the loan be taken out using your name or your business/entity name?(Required)

Business/entity name(Required)

How will you send your funds?(Required)

Wiring instructions and the mailing address for the check will be sent via email immediately upon completion of the application. If you don't receive it, please check your spam/junk folder.

Your Date of Birth(Required)

Must be over 18 years of age to participate in this program

MM slash DD slash YYYY

Spouse's Date of Birth

Must be over 18 years of age to participate in this program

MM slash DD slash YYYY

Email(Required)

Contract, documents and renewal notices will be sent to this email.

Spouse's Email

Contract, documents and renewal notices will be sent to this email.

Cell Phone Number(Required)

Address(Required)

Use your address as shown on your income tax return

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Underwriting

Underwriting(Required)

I certify that the source of funds I am providing for this loan has not come in part or in whole from any illegal or illegitimate source(s).(Required)

Consent 2(Required)

I certify that the source of funds I am providing comes from expendable income.(Required)

Consent 3(Required)

I certify that I have spoken with my financial advisor to ensure this is a suitable option for me.(Required)

Consent 4(Required)

In the event that my loan is paid out later than the specified period specified in this contract, I understand that interest will be prorated accordingly.(Required)

Initial(Required)

Enter your initials to signify that you have read and agree with the information above.

Federal Tax Classification(Required)

Choose the appropriate option for your business.

Individual/sole proprietor or single-member LLC

Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership)

C Corporation

S Corporation

Partnership

Trust/Estate

Other (Such as Charitable LLC)

Choose the tax classification

Enter other classification

Social Security Number(Required)

For tax purposes the government requires us to gather this information. This is a secure connection. Your information is not saved on our site and is never shared with anyone.

Employer Identification Number(Required)

For tax purposes the government requires us to gather this information. This is a secure connection. Your information is not saved on our site and is never shared with anyone.

Signature(Required)

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

Financial Consultant