1. Are you an existing borrower of KSEYE, or have you previously been a borrower of KSEYE?YesNo2. Are you a sole trader, a partnership, a company, or an individual acting on behalf of a company?YesNo3. Is your business based in the UK?YesNo4. Does your business have a turnover of no more than £45 million? Note: If your business is part of a group, the maximum turnover applies to the group undertaking. The qualifying period is the 12 months preceding the application.YesNo5. Does your business generate more than 50% of its turnover from trading or commercial activity in the UK? Note: “Trading activity” means any trading or commercial activity that generates turnover (whether or not it is carried on with the intention of making a profit and whether or not turnover is generated by exports). This includes real-estate SMEs that derive income from property (including real-estate investment companies and housebuilders).YesNo6. Are you looking for a secured term loan of between £250,000 - £5,000,000?YesNo7. Are you able to provide real estate collateral as security for a CBILS loan, excluding any principal private residences?YesNo8. Has your business been impacted by Covid-19?YesNo9. Is your business currently a “business in difficulty”? Note: This can be self-certified by micro and small businesses that have fewer than 50 employees and less than £9,000,000 in annual turnover and/or annual balance sheet total. All other businesses must evidence that they: (1) have not entered into collective insolvency proceedings; (2) have not accumulated losses greater than half of their capital/share capital in their last annual accounts (this does not apply to SMEs less than 3 years old); and (3) are not in receipt of rescue aid which has not yet been repaid or restructuring aid, nor are they subject to a restructuring plan.YesNo10. Do you have a viable business proposition, notwithstanding the short-to-medium effects of Covid-19?YesNo11. Is the loan for working capital, investment or refinancing of debt?YesNo12. Does your business operate in one of the following sectors? • Banks, building societies, insurers and reinsurers (but not insurance brokers) • Public- sector bodies • State funded primary and secondary schoolsYesNo13. Is your business currently using or applying for a loan under the Bounce Back Loan Scheme (BBLS), the Coronavirus Large Business Interruption Loan Scheme (CLBILS) or the Bank of England’s COVID Corporate Financing Facility (CCFF)?YesNo Contact Name (required) Company Name (if applicable): Address: (required) Telephone: (required) Email (required) DeclarationsI/We confirm that the information given above is true, accurate, complete and up-to-date.I/We confirm that KSEYE may use and process the personal information provided in line with its prevailing Privacy Notice and in accordance with the Data Protection Act 2018 (as amended from time to time).I/We confirm that I/we have read KSEYE’s Privacy Notice, a copy of which is available online at www.kseye.co.uk/privacypolicy/, and that I/we understand the rights that KSEYE has in relation to my/our personal information.Email Marketing PreferencesAs an actual/prospective borrower of ours, we would like to let you know about our latest products and offers by email. You can unsubscribe from these emails at any time. If you do not want to receive these marketing emails, please tick the box below to opt out.I/We do not want to receive marketing emails about your latest products and offers. YesNoAcceptance of Declarations and SubmissionI/We confirm that we agree to and accept the Declarations set out above and that I/We wish to proceed with a CBILS application.