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Funding Application

1-866-363-9273

Funding Application

Fill out the form the see the eligibility status

"*" indicates required fields

Step 1 of 4

25%

Business Information

Business Legal Name*

DBA

Business Phone Number*

Business Website

Legal Entity*

Corp

Sole Prop

LLC

Partnership

State of Organization*

EIN*

Business Start Date*

MM slash DD slash YYYY

Industry Type*

Type of Product/Service Sold:

Was Business Purchased from a Previous Owner?*

Yes

No

Date Current Ownership Started*

MM slash DD slash YYYY

Does your business have any current advances or loans?*

Yes

No

With Who?

What is your current balance?

Did you speak to one of our funding managers already?*

If you have not spoken to rep or don't remember select "No"

Yes

No

Funding Manager*

Business Location Information

Business Address*

Street Address Suite/Fl City State ZIP Code

Is the billing address different?*

Yes

No

Billing address

Street Address Suite/Fl City State ZIP Code

Business Location is*

Rent

Mortgage

Own-Outright

Monthly Rent/Mortgage*

Are you current with rent/mortgage?

Yes

No

N/A

Landlord Name

First Last

Landlord Phone

Remaining length of lease

Use of Proceeds and Bank info

Amount Requested*

Use of Proceeds*

Gross Annual Sales (Prev. Year's Tax Return)*

Do you accept credit cards?*

Yes

No

Average Monthly Credit Card Volume

Average Monthly Deposits/Volume*

Last 3 Months Bank Statements

Please upload your last 3 months bank statements (4 Months if in CA)

Drop files here or

Accepted file types: pdf, jpg, Max. file size: 512 MB.

Owner's Information

Owner/Officer's First Name:*

Owner/Officer's Last Name:*

Owner's Phone Number*

Owner's Email*

Owner's SSN*

Owner's Job Title*

CEO

CFO

COO

President

VP

Other

% of Ownership*

Owner's DOB*

MM slash DD slash YYYY

Owner's Address*

Street Address City State ZIP Code

Citizenship*

US Citizen

US Permanent Resident

Other

2nd Owner?

Yes

No

2nd Owner/Officer Name

Phone Number 2nd Owner

Email 2nd Owner

SSN 2nd Owner

Job Title 2nd Owner

CEO

CFO

President

VP

COO

Other

2nd Owner % of Ownership

2nd Owner DOB

MM slash DD slash YYYY

2nd Owner Street Address

Street Address City State ZIP Code

Citizenship

US Citizen

US Permanent Resident

Other

Owner's Signature*

Owner 1 Signature Date*

MM slash DD slash YYYY

Owner 2 Signature

2nd Owner Signature Date

MM slash DD slash YYYY

Comments

This field is for validation purposes and should be left unchanged.

Fundward offers an experienced and responsive team who listens, creates tailored business funding solutions that fit each individual's needs, and works with a 99% approval rating! Secure working capital today so that your company can not only survive but thrive too.

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