Minimum Requirements to Apply: Have Been in Business at Least 3+ Months 475 or Higher Personal Credit Score Business Checking Account in Business Name With at Least 3 Months History (NO personal accounts allowed.) $5,000+ in Monthly Revenue Deposits to Above Business Checking Account Each of the 3 Months Before Applying Business InformationHow Much In Funding Do You Need?*Select One$5K$5 – $10K$10 – $25K$25 – $50K$50 – $100K$100 – $250K$250 – $500K$500 – $1MM$1MM – $2MM$2MM – $3MM$3MM – $4MM$4MM – $7.5MM$7.5MM – $10MMWhat Will You Use the Funds For?*Select OneBusiness ExpansionBuy Inventory or SuppliesCash Flow or General Working CapitalDebt ConsolidationMake PayrollMarketing or AdvertisingPay RentPurchase EquipmentTaxesRenovationsOtherHow Soon Do You Need Funds?*Select OneToday If PossibleWithin 48 Hours3 Days – 2 WeeksWithin 3 – 4 WeeksWhat Is Your Monthly Revenue?*Select One$5,000 min. required$6,000 – $10,000$10,000 – $25,000$25,000 – $50,000$50,000 – $100,000$100,000 – $250,000$250,000 – $500,000$500,000 – $750,000$750,000 – $1,000,000More than $1,000,000How'd You Hear About Us?*Select OneTelephone CallEmailTextSocial MediaVideoOnline SearchTVMailRadioReferralFinancing Program Wanted?*Select OneWhatever I Am Approved ForWorking Capital LoanConsolidationRevenue Share FinancingTerm LoanBusiness Line of CreditRevenue Based FinancingFix and Flip LoansAsset-Based LoansCommercial Real EstateSBA LoansInvoice FactoringEquipment FinancingPurchase Order FinancingLegal Business Name*DBA Business Name*Name* First Last Cell Phone Number*Email* Address* Business Street Address City State / Province / Region ZIP / Postal Code (No PO Boxes allowed) Business Financial InformationFederal Tax ID Number*State of Incorporation* State / Province / Region Business Start Date* Legal Business Structure*Select OnePartnershipCorporationLLCSole PropreitorshipCompany Website*If no website, put “None”.Products/Services Sold*Do you have any business loan balances open with another company?*YesNoCompany Name Loan #1Date Funded Approximate BalancePayment AmountCompany Name Loan #2Date Funded Approximate BalancePayment AmountPrincipal Owner #1Name* First Last Address* Street Address Apt/Unit/Suite City State / Province / Region ZIP / Postal Code Birth Date* Cell Phone Number*Email* Your Credit Score*Select OnePoor (300 – 579)Fair (580 – 649)Good (650 – 739)Very Good (740 – 799)Excellent (800 – 850)Social Security Number*% Ownership*I Own 100%I Own Less Than 100%Principal Owner #2Name* First Last Address* Street Address Apt/Unit/Suite City State / Province / Region ZIP / Postal Code Birth Date* Cell Phone Number*Email* Your Credit Score*Select OnePoor (300 – 579)Fair (580 – 649)Good (650 – 739)Very Good (740 – 799)Excellent (800 – 850)Social Security Number*Upload Business Checking Account StatementsRequired For Approval – Upload Last 3 Months Business Checking Account Statements & a Printout of All Activity for the Current Month Estimated Approval 3 – 4 HoursAttach March Business Checking Account Printout of All Activity Month to Date Here*Accepted file types: pdf.Attach February Final Business Checking Account Statement Here*Accepted file types: pdf.Attach January Final Business Checking Account Statement Here*Accepted file types: pdf.Attach December Final Business Checking Account Statement Here*Accepted file types: pdf.DISCLOSURE The Owner(s)/Officer(s) identified above (individually, an “Applicant”) each represents, acknowledges and agrees that: (1) all information and supporting documents are true, accurate and complete and that you will notify us of material changes to such information (2) Applicant authorizes us to disclose all information and documents that we may obtain including credit reports to other persons or entities (collectively, “Assignees”) that may be involved with acquiring business loans having daily, weekly, or monthly repayment features or purchases of future receivables including Merchant Cash Advance transactions and Revenue Based Funding transactions including without limitation the application (collectively, “Transactions”). Each Assignee is authorized to use such information and documents with other Assignees, in connection with potential Transactions, (3) You are authorized to apply on behalf of the company whose full legal name appears above under the Company/Business Information portion of the Application for Transactions. (4) You understand that we and our representatives, successors, Assignees and designees (collectively, “Recipients”) are authorized to request and receive any investigative reports, credit reports, statements from creditors or financial institutions, verification of information, verification of references or any other information that a Recipient deems necessary in evaluating your application. (5) Applicant waives and releases any claims against Recipients and any information-providers arising from any act or omission relating to the requesting, receiving or release of information. (6) You expressly consent to receiving calls including automated dialer calls, SMS messages, faxes, and e-mails from us, our affiliates, and Assignees and you may withdraw your consent by notifying us in writing.I Agree* I agree with the terms and conditions of this Disclosure. Owner #1 Signature*Date* Owner #2 Signature*Date*
