Paycheck Protection Program

Paycheck Protection Program

Borrower Application Form
There is a 10% back end fee due within 24 hours upon the funds being deposited. A Late fee of $50 will be applied after 48 hours on being funded.
Is this your 1st or 2nd Draw?

Select One1st2nd
Previous PPP Loan Amount
PPP Loan E-Tran Number
PPP Loan Agreement

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If you received a prior loan Cancelof
We're you in business prior to January 31, 2020

Select OneYesNo
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Personal Email
example@example.com
Social Security Number
Date of Birth

MonthDayYear
Date
Kindly Check Select Only One

Sole ProprietorLLC501(c) (3) non-profit501(c) (19) Veterans OperationS-CorpC-CorpEligible self-employed IndividualPartnershipIndependent ContractorTribal Business (SEC. 31) (b) (2) (C) of Small Business ActOther
2019 Total Income
2020 Total Income
940- Yearly Payroll or W2 Payroll 941- Quarterly payroll for the Year (All 4 Quarters)

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Schedule C or P&L's for 2019

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Complete copy of Tax forms 1040 and Schedule C for 2019

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Schedule C or P&L's for 2020"

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Bank Statement of Feb 2020

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Voided Check

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Valid ID Front and Back

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- Applicant is not engaged in any illegal activity as defined by the Federal guidelines
- No principal of the Applicant with a 50% or greater ownership interest is more than sixty (60) days delinquent on child support obligations
- Applicant does not present live performances of a pruruent sexual nature are derive directly or indrectly more than the minimis gross revenue through sale of products or services, or the presentation of any depictions or displays, of a prurient sexual nature.
- Applicant does not derive more than one-third of gross annual revenue from legal gambling activities.
- Applicant is not in the business of lobbying
- Applicant is not a State, Local, or Municipal Government entity and cannot be a member of Congress
- You Agree that the above statements does not apply.
Is this a Personal or Business Account?
Routing Number
Account Number
Business Legal Name
What Date was your Business Establish

MonthDayYear
Month/date/year
Business EIN
Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Business Phone

Country CodeArea CodePhone Number
Primary Contact

Country CodeArea CodePhone Number
Email
example@example.com
Average Monthly Payroll
Number of Employees (Contractors or not direct employees)
List of all owners 20% or more of the equity of the Applicant. Attach a separate sheet if necessary
Owner Name / Title / Ownership % / EIN/ Address
Put every details that required Name, Title, Ownership %, EIN, Address
BFN Affiliate Name
Name
Date

MonthDayYear
Date
By signing and initialing this document, I understand that I will not initiate any new inquiries on my credit during the application phase of the Davis Thorpe & Associates INC / Business Funding Now business credit program. In the event that I do initiate any new inquiries on my credit without permission from my funding manager, I may be found to be disqualified from the DTA/BFN Financial Program
Select One Type of Agreement*

Credit Card Authorization AgreementBank ACH Authorization Agreement
Credit Card Authorization Agreement
Type of Credit Card
Card Number
Expiration / CVV
Type of Card

VISAMCAMEXDISC
Name as it Appears on Card
Billing Address
City
State
Zipcode
I certify that I am the authorized holder and signer of the credit card reference above. I certify that all information above is complete and accurate. I hereby authorize collection of payment for all charges as indicated above. Charges may not exceed your invoiced amount or amount owed per this agreement. I understand this is only for up to this amount during the time period of "DATES OF CHARGES" referenced above. If additional charges are going to be authorized a new form will have to be completed.
Name
Date

MonthDayYear
Date
Bank ACH Authorization Agreement
Company / Personal Name
Bank Name
Routing Number
Checking Account Number
Address on Check
City
State
Zip Code
I hereby authorize Davis Thorpe & Associates INC / Business Funding Now (hereinafter “Company”), and its assignee to initiate credit and, if necessary, debit entries and adjustments for any credit entries in error to my (our) Checking Account at the depository institute indicated below (hereinafter “Depository”), to credit and/or debit the same to such account. I hereby also agree to use my account below to collect on my invoice with Davis Thorpe & Associates INC / Business Funding Now.
Should be Empty:

Paycheck Protection Program

There is a 10% back end fee due within 24 hours upon the funds being deposited. A Late fee of $50 will be applied after 48 hours on being funded.

Credit Card Authorization Agreement

Bank ACH Authorization Agreement