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This funding is unsecured & will not disqualify you from receiving other loan options. Example: SBA Loans, PPP, EILD.

Requirements: Minimum 1+ year in business & 250k+ annual revenue

Great option if:

You can put funds to use tomorrow

Would like a bridge loan while you wait to hear back on other loan options

Waiting on your customers to pay you

Would like some "cushion" or general working capital
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Desired Loan Amount* This field is required.How much do you need?
3
Purpose of Loan* This field is required.
Working Capital
Bridge Loan
Inventory
Equipment
Payroll
Other
4
Please Specify
5
How soon can you put the loan to use?* This field is required.
ASAP
2 to 4 Weeks
Next Week
Over 1 Month
6
Average Monthly Gross Sales* This field is required.Can be an estimate, doesn't have to be exact
7
Do you have a balance(s) with another lender(s)?
YESNO
8
SF - Balance with another lenderFor Salesforce integration
YES
9
Who is the lender(s)?
10
What is the estimated balance(s) with that lender?
11
Legal Name of Business* This field is required.
Example: Affinity Beyond Capital Inc
12
DBA (optional)If different than legal name
Example: Affinity Beyond Capital
13
Business Address* This field is required.
Street Address
Street Address Line 2
City
Please Select
Please Select
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
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Please Select
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curacao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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Business Location* This field is required.
Lease
Mortgage
Own
15
LeaseFor Salesforce integration
Lease
16
MortgageFor Salesforce integration
Mortgage
17
OwnFor Salesforce integration
Own
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Business Entity* This field is required.
Corporation
Partnership
LLC
Sole Proprietorship
Non-Profit
19
CorporationFor Salesforce integration
Corporation
20
PartnershipFor Salesforce integration
Partnership
21
LLCFor Salesforce integration
LLC
22
Sole ProprietorshipFor Salesforce integration
Sole Proprietorship
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Non-ProfitFor Salesforce integration
Non-Profit
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Are there tax liens or judgments against the business?* This field is required.
YESNO
25
SF - Tax LiensFor Salesforce integration
YES
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Federal Tax ID #* This field is required.
27
Website
28
OLD Industry
Manufacturing, Finace, etc.
29
Industry* This field is required.
Administrative
Agriculture / Land Management
Animal Related
Arts / Entertainment / Recreation
Automotive
Construction
E-commerce Trade
Educational Services
Finance and Insurance
Health and Beauty
Information Technology / Scientific
Manufacturing
Medical / Health Care / Social Assistance
Other
Other Services
Professional Services
Real Estate
Rental / Leasing
Restaurants / Hotels / Hospitality
Retail Trade
Transportation and Warehousing
Utilities / Waste Management
Wholesalers
Please select an industry
30
Business Start Date* This field is required.If you don't remember the month and day, enter 01/01 and the year business was started
Date
Month
Day
Year
31
Phone Number* This field is required.Business Phone Number
32
Email Address* This field is required.
example@example.com
33
First & Last Name* This field is required.
34
Cell Phone* This field is required.Best Contact Number
35
Home Address* This field is required.
Street Address
City
State | Example: NY
Zip Code
36
Home StreetFor Salesforce integration
37
Home CityFor Salesforce integration
38
Home StateFor Salesforce integration
39
Home Zip CodeFor Salesforce integration
40
Credit Score Range* This field is required.
480 - 550
551 - 620
621 - 680
681 - 750+
41
Credit Score | 480 to 550For Salesforce integration
480 - 550
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Credit Score | 551 to 620For Salesforce integration
551 - 620
43
Credit Score | 621 to 680For Salesforce integration
621 - 680
44
Credit Score | 681 to 750+For Salesforce integration
681 - 750+
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Ownership %* This field is required.
46
Date of Birth* This field is required.
Date
Month
Day
Year
47
Social Security Number* This field is required.
48
Have You Applied for the COVID-19 Economic Injury Disaster Loan (EIDL) & Advance?The EIDL loan is up to $2 million. The advance is up to $10,000 and doesn't have to be repaid.
YESNO
49
Are You Interested in Applying for the EIDL & Using Our Services to Assist You?
YESNO
50
SignatureBy signing below, each of the above listed business and business owner/officer (individually and collectively, “you”) authorize Affinity Merchant Services, Inc. (“Affinity Beyond Capital”) and each of its representatives, successors, assignees and designees (“Recipients”) that may be involved with or acquire financing through alternative credit facilities including, but not limited to daily repayment features or purchases of future receivables including Merchant Cash Advance transactions, including without limitation the application therefore (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 Affinity Beyond Capital 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 Affinity Beyond Capital and to each of the Recipients, on its own behalf.
Clear
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DATE
Date
Month
Day
Year
52
Lead SourceFor Salesforce integration
Website
Website
53
Jotform?For Salesforce integration
Yes
Should be Empty: