A-Team Business Funding Assessment

Owner Info
Name *

First Name Last Name
Date of Birth *

Month Day Year
Date
Social Security Number *
Are you a United States Citizen? *

Yes No
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number *

Area Code Phone Number
Email *
example@example.com
Percentage of Ownership *
Are there any additional owners? *

Yes No

Business Info
Business Name *
If a Sole Proprietor please insert first and Last name
Trade Name
List your Doing Business As name here
Business Formation *
EIN *
if none, please list your SSN
Industry *
When did you first start operating this business? *

Month Day Year
Date
Date Formed *

Month Day Year
Date
Business Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number *

Area Code Phone Number
Email *
example@example.com
Number of Employees *
Last Year Annual Revenue *

Banking Info
Name of Bank *
Routing Number *
Account Number *
Name on Account *
Please upload your last 3-6 months of bank statements *

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Agreements
Acknowledgment

I, First Name* Last Name*, attest that all of the information provided in this application is true to the best of my knowledge. I attest that I am aware that The A-Team Professionals & Co is using the information provided in this application, to process an EIDL application, issued by the Small Business Association. I understand that The A-Team Professionals & Co is not responsible for the approval or denial of my application.

I understand that any amount of money that is received from the SBA by me, I am responsible to repay the loan according to the repayment terms set forth by the SBA.

I understand that if I do not repay the loan. That I am and my company will be held liable according to the default term set forth by SBA.

Signature* Date*
Please upload a copy of your Government issued ID/DL or Passport

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Cancel of
One-Time ACH Payment Authorization

I, First Name   Last Name, acknowledge that I am an owner of (or authorized signer on) the below referenced account to be debited and hereby authorize for the sum agreed. I understand that The A-Team Professionals & Co will debit my account within 48 hours after funding of my loan from the SBA for services rendered and to initiate. I understand that my account will only be debited. If and only if I do not pay my invoice in full within 24 hours after funding takes place. if necessary, credit entries and adjustments for any-debit entries in error to my (our) account indicated below.

I understand that if the funds are not in my account to cover amount of services I will occur additional fees to include charge backs, NFS fees and if need be legal or debt collection fees.

Account type: Checking   Savings   Business Savings
Account Name
Bank Name
Account Number
Routing Number

Signature   Date

I understand that because this is an electronic transaction. In the case of the payment being rejected for Non-Sufficient Funds (NSF) I understand that The A-Team Professionals & Co may, at its discretion, attempt to process the charge again within 30 days, and I agree to the additional charge for each attempt returned NSF, which will be initiated as a separate transaction from the authorized payment. I acknowledge that the origination of ACH transactions to my account must comply with the provisions of U.S. law. I will not dispute The A-Team Professionals & Co billing with my bank so long as the transaction corresponds to the terms indicated in this agreement.
Please upload a copy of a voided check from the aforementioned account

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How did you hear about us? *
Referral name/source
Should be Empty:

Owner Info

Additional Owners

Business Info

Banking Info

Loan Information

Eligibility

Additional Information

Agreements