PRE-LOAN / LEASE APPLICATION

Principal’s Name:
Ross Lyndon-James Industry: Consumer Products
Amount of Financing
Title: CEO > $100k
Requested:

Company name: Galexxy Corp Purpose of Financing: Working Capital

4630 Campus Drive Funding required for
Suite 104 sample production &
bridging finance until
Brief Description about
Street Address: public offering funding is
Financing Purpose: received

Newport Beach Personal Guarantees Yes

City / Town: Available:
(start up in cannabis a must)

State / Province: California Credit History of Owner:

Zip / Postal Code: 92660 Credit History of Company: Nil early stage
Telephone No. Purchase Price: $

Cellular Phone: 949 456 3972 Cash Invested by Buyer: $

Fax: Total Business Assets: $

Email: ross@galexxy.com Total Liabilities: $

Start-Up/Existing
Start-up Total Business Net Worth: $ IPO @ $4m
Business:
Years in Business: 6 mths Company's Annual Revenue: $ Pre revenue
Business Type: CBD Online Retail Company's Annual Profit: $ N/A

For Agents Use Only

HEF Agent Name: Charles Lloyd Agent Company’s Name:

Agent Email: Agent Phone Number:

SMZ Capital Group & Partner

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