Submit Your Application
Step
1
of
4
25%
Contact Information
Business Name
(Required)
DBA Name
Business Email
(Required)
Business Phone Number
(Required)
Applicant Name*
(Required)
First
Last
Consent
(Required)
I agree the following:
By signing below, each of the above-listed business and business owner/officer (individually and collectively, “you”) authorize Business Lending (“BusinessLending”) and each of its representatives, successors, assigns and designees (“Recipients”) that may be involved with or acquire commercial loans having daily repayment features or purchases of future receivables including Merchant Cash Advance transactions, including without limitation the application therefor (collectively, “Transactions”) to obtain consumer or personal, business and investigative reports and other information about you, including credit card processor statements and bank statements, from one or more consumer reporting agencies, such as TransUnion, Experian and Equifax, and from other credit bureaus, banks, creditors and other third parties. You also authorize BusinessLending to transmit this application form, along with any of the foregoing information obtained in connection with this application, to any or all of the Recipients for the foregoing purposes. You also consent to the release, by any creditor or financial institution, of any information relating to any of you, to BusinessLending and to each of the Recipients, on its own behalf. You also authorize BusinessLending and each of its Recipients to contact you via text message, automated call or email message at the contact information listed above. Notwithstanding the foregoing, you may, at any time, opt-out of text messaging, automated call or e-mail messaging by clicking on the link provided at the end of any such communication or otherwise contacting BusinessLending. Further you may revoke any consents provided above regarding the procurement or disclosure of any information or otherwise correct or request a copy of any information BusinessLending maintains about you by contacting BusinessLending.
Business Information
Business Address
(Required)
Street Address
Address Line 2
City
State / Province
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Estimated Yearly Revenue
(Required)
State of Incorporation
(Required)
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
Canada
Puerto Rico
Virgin Islands
Business FICO Score
(Required)
Federal Tax ID
(Required)
Do you process credit cards?
(Required)
Yes
No
Year and Month Business Started
(Required)
MM slash DD slash YYYY
Do you have any merchant cash advances currently?
(Required)
Yes
No
Merchant Cash Advance/Business Loan Lender(s)
(Required)
Merchant Cash Advance/Business Loan Balance
(Required)
Applicant Information
Applicant Title
(Required)
Ownership Percentage %
(Required)
Applicant Personal Address
(Required)
Street Address
Address Line 2
City
State / Province
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Personal Phone Number
(Required)
Date of Birth
(Required)
MM slash DD slash YYYY
SSN
(Required)
Second Owner
(Required)
Yes
No
Second Owner Name
(Required)
First
Last
Second Owner Email
(Required)
Second Owner Phone Number
(Required)
Second Owner Title
(Required)
Second Owner Address
(Required)
Street Address
Address Line 2
City
State / Province
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Second Owner Percentage %
(Required)
Second Owner SSN
(Required)
Second Owner Credit Score
(Required)
Second Owner DOB
(Required)
MM slash DD slash YYYY
Please upload your most recent 4 months of business bank statements. If your business operates seasonally, please ensure you upload the most recent 12 months of your business bank statements to provide a complete financial overview. This helps us accurately assess your business's cash flow and overall financial health throughout the year.
Drop files here or
Select files
Accepted file types: pdf, jpg, png, doc, docx, psd, xls, xlsx, txt, Max. file size: 2 GB.
If you're already working with a funding specialist, please put their name here.
Signature
(Required)
Second Owner Signature
(Required)
Submit Date
(Required)
MM slash DD slash YYYY
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