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Funding Application
1-866-363-9273
Funding Application
Fill out the form the see the eligibility status
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Business Information
Business Legal Name
*
DBA
Business Phone Number
*
Business Website
Legal Entity
*
Corp
Sole Prop
LLC
Partnership
State of Organization
*
AK
AL
AR
AZ
CA
Canada
CO
CT
D.C.
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
EIN
*
Business Start Date
*
MM slash DD slash YYYY
Industry Type
*
Choose Industry Type
Accounting
Adult Entertainment
Adult Materials
Advertising
Agriculture
Air Craft Dealerships
Airlines
Annual Memberships
Answering Services
Appraisal Services
ATM Businesses
Attorneys
Auction Houses
Auditing
Auto Sales
Auto Repair
Aviation
Bail Bonds
Bankrupt Franchises
Banks
Bars
Beauty Bars
Blood & Organ Banks
Boat Sales
Bookkeeping
Brokerage Development
California
Call Centers
Cannabis
Cannabis Dispensary
Cannabis Farming
Car Dealers
Car Services: Uber, Lyft
Cash Exchange
Casinos
Cattle
CBD
Cell Phone Repair & Parts
Central Reserve Depository
Check Cashing
Child Care
Civic Organizations
Class 3 Weapons
Collection Agencies
Commercial Banks
Consignment
Consolidations
Construction
Consulting
Consumer Credit
Contracted Management Services
Contractor
Convenience Stores
Courts
Credit Card Processing
Credit Protection
Credit Repair
Credit Restoration
Credit Unions
Dating Services
Daycare
Debt and Tax Reduction Services
Debt Buyers
Debt Collection
Debt Consolidation
Defaults
Delivery Services
Discount Travel Clubs/Subscriptions
Drop Shippers
Drug Dispensaries
Drug Paraphernalia
Elementary Schools
Energy Deals
Energy Distribution
Energy Generation
Escort Services
Escrow Agents
Event Promoters
Event Ticket Sales
Executive Offices
Factoring
Farming
Farming & Agriculture
Farms
Feed Stores
Fencing
Financial Lenders
Financial Planning
Financial Services
Fire & Water Restoration
Firearms
Fitness Centers
Flea Markets
Flooring
Food & Beverage
Food Courts
Foreign Bank and Branches
Forestry
Fortune Telling
Fracking
Freight Forwarding
Funders
Furniture
Gambling
Gaming
Gas Stations
Gas Transportation
General Government
General Government Support
General Partnerships
Government
Gun Stores
Guns & Ammo Manufacturing
Guns & Ammo Sales
Gym
Hair Salons
Hazmat
Herbal Supplement Companies
Historical Sites
Holding Offices
Holistic Doctors
Home Based Businesses
Home Health Care
Home Heating
Homebuilders
Homeopathy/Natural Medicine
Horoscope
Hotels
House Flippers
Hunting
Import/Export
Influencers
Insurance
Insurance Agencies
Investment Brokers
Investment Opportunities and Advice
IT Services
Kiosks
Labor Organizations
Lawyers
Lead Sales
Legal Services
Legislative Bodies
Lenders
Lessors
Life Insurance
Limousine
Live Animals
Livestock
Livestock Wholesalers
Logistics
Logistics under $3M
Lotteries
Magazine Subscriptions
Mail Order Coin Sales
Mailing & Fulfillment Houses
Mailing Companies
Manufactured/Mobile Home Sales
Marketing
MCA Competitors
Media Publishing
Medical
Mini Markets
Mining
MLM
Mobile Home Park
Mobile Home Sales
Money Service Businesses
Mortgage Lenders
Motion Pictures
Motorcycle Sales
Museums
Nail Salons
National Security
NEC
New Home Construction
Night Clubs
No Open Bankruptcies
No Previous Defaults
Non-Bank Finance Companies
Non-Profits
Non-US Companies
Notaries
Nursing Home
Oil & Gas
Oil Drilling
Oil Fields
Oil Transportation
Online Auctions
Online Marketing
Online Merchants
Online Supplements
Online Weight Loss Products
Pawn Shops
Pay Day Loans
Payroll Companies
Pension Funds
Performing Arts Schools
Personal Care Facilities
Personal Trainers
Pet Adoption
Places of Worship
Political Campaigns
Political Organizations
Pornography
Postal Services
Power Distribution
Power Generation
PR Firms
Precious Metal Sales
Prepaid Telephone Access
Print Media
Printing Services
Private Households
Private Investigators
Produce
Public Order & Safety
Public Traded Companies
Publishing
Purchase Order Financing
Quarrying
Raffles
Rail Transportation
Real Estate Brokers
Real Estate Investment
Real Estate Managers
Real Estate Sales
Recreation
Recruiting
Referral Marketing
Religious Organizations
Rental Properties
Repossession
Residential Remodeling
Restaurants
Restaurants w/o Take Out
Restaurants with Take Out
Retail
Retail: Appliances
Retail: Jewelry
Roofing
Rooming & Boarding
RV & Trailer Sales
Savings Institutions
Schools
Securities & Commodities
Security Services
Social Services
Solar Companies
Solar Power Resellers
Sole Proprietary
Space Research & Technology
Staffing
Staging
Stenography & Court Reporters
Stock Brokerage
Strip Clubs
Tax Companies
Taxation
Taxi Companies
Telecommunications
Telemarketing
Telephone Resellers
Ticket Broker
Title Abstract Offices
Title Companies
Tobacco
Tobacco Shops
Tour Operators
Towing
Trade Associations
Transportation
Travel Agencies
Truck Sales
Trucking
Unapproved Medical Treatments
Urban & Community Development
Used Car Dealerships
Utilities
Vacations & Rental Lodging
Vape Shops
Vehicle Manufacturing
Vice Shops
Video Rental
Virtual Currency
Visual Merchandising
Warranty Companies
Water Transportation
Wholesale
Wildlife Conservation
Wireless
Wireless Telecommunication Stores
Zoos
Other
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
*
Select a Funding Manager
Andrew Alicea
Benjamin Campopiano
Blake Reynolds
Terry Mack
Dan Kennedy
Edward Thompson
Gabriel Lucin
Griffin Weber
Roger Coates
Jeff Paul
Joseph Lanigan
Justin Philipps
Jason Padilla
Patrick Liu
Tom Stout
Tristen Scott
Business Location Information
Business Address
*
Street Address
Suite/Fl
City
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
Is the billing address different?
*
Yes
No
Billing address
Street Address
Suite/Fl
City
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
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
*
Expansion
Equipment
Working Capital
Inventory
Real Estate
Other/Miscellaneous
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
Select files
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
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
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
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
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
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Third Choice
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Second Choice
Third Choice
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