Strategic Application Form

Application Form

Direct: (800) 826-3069
Legal Business Name (click + to add DBA)
Business Number

Area CodePhone Number
Email
Amount Requested
Business Address

Street Address

Street Address Line 2

CityState / Province

Zip Code
Business Structure/Type
Industry Type
Annual Revenue
Business Start Date
Tax ID Number
CC Percentage of deposits
Existing Loan/Advance Balance
Liens / Judgments / Claims
Rent or Own
Ownership Information
Officer/Owner Name

First NameLast Name
Mobile Number

Area CodePhone Number
Email
SSN
Home Address

Street Address

Street Address Line 2

CityState / Province

Zip Code
Ownership Percentage
Estimated FICO Score
Date of Birth

MonthDayYear
Date
Second Officer/Owner Name

First NameLast Name
Mobile Number

Area CodePhone Number
Email
SSN
Home Address

Street Address

Street Address Line 2

CityState / Province

Zip Code
Ownership Percentage
Estimated FICO Score
Date of Birth

MonthDayYear
Date
Collateral
What type of collateral
Total Estimated Value:
Total Estimate Debt Amount:
Terms & Conditions: The Merchant and business Owner(s) identified on this application (individually, the "Applicant") each represent, acknowledges and agrees that (1) all information and documents provided to Strategic Lending Group (SLG), represent a true, accurate and complete discription of business and applicant. (2) By submitting this application Applicant authorises SLG and/or it's funding partners to request, obtain and receive any investigative reports, credit reports, statements of creditors or financial institutions, verification of information or other information deemed necessary to evaluate Applicant. (3) Applicant waives and releases SLG from any claims arrising from the release of and/or the receipt of information relating to applicants request for business financing. (4) Owner/Applicant represents that he or she are authorised to sign this form on behalf of the business and agree to receive all forms of communication (calls, email text, other) from SLG and it's agents.
Name

First NameLast Name
Signature
Second Owner

First NameLast Name
Signature
TodaysDate

MonthDayYear
Date
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Application Form

Ownership Information