Survey

Name of Business ( Optional)

What do you sale or manufacture? ___________________________________

Type of Business: Service _____ Manufacturing ____ Other ______

Number of Years/Months in Business? ________

Annual Sales? _____________

Have you obtained a loan from any source for the business? Yes ______ No _______

If yes, from what source and how much (check all that apply):
Family / Friends $____________;
Non Profit Agency $____________ (e.g. ACCION, Business Outreach Center, Project
Enterprise);
Governmental Agency $ ____________ (e.g. SBA, Empire State Development, UMEZ);
Bank $____________
Other __________________ $______

Do you anticipate seeking a loan within the next 12 months? Yes _____ No _______

If yes for what amount, and for what purpose: $ ___________

Purpose: Inventory ___ Equipment ___ Working Capital ____
Leasehold Improvements ____ Mortgage _____ Other _________

Do you have a Bank account for your business? Yes ___ No ____

List all of the type of bank accounts you have whether business or personal:

If you have a bank account, how can your bank improve its service to meet your
business/personal needs?

What banking services are you interested in learning more about (check all that apply):
Business loans ____; Checking account ____; Investment/Brokerage account ____;
Commercial Mortgage ___; Residential mortgage ____; Credit Card ___:
Personal Loans ____; Other _______

“Please write down any other questions or comments you may have on the back of this
page”.

Can we talk to you about this survey if more information or clarification is needed? If so, please
provide your name and telephone number, or email address below.

Name telephone number

E-mail address
 Survey (continued)
What is the smartest business move you have made:

What would you advise a new business owner / entrepreneur NOT to do?

How would you rate the service you received from a bank, governmental agency,
or non-profit loan / technical assistance provider?
Excellent __ Very Good __ Satisfactory __ Fair __ Poor __

What do you base this rating on?

What can small business agencies and banks do to assist in your success?

What do you wish you had known before starting your business?

What is stopping your business from moving forward?

Do you have a business plan and marketing strategy?