Business Funding Application

Business Legal Name*

EX: ABC Towing, LLC

DBA (Doing Business As) - If applicable*

Legal Entity*

Sole ProprietorshipPartnershipCorporationLLC

Federal Tax ID*

Federal Tax ID

Business Phone Number*

Business Phone Number

Business Email Address*

example@example.com

Business Start Date*

Date

Business Address*

Street Address

Street Address Line 2

CityState

Zip Code

Name of Business Owner*

First NameLast Name

Home Address*

Street Address

Street Address Line 2

CityState

Zip Code

E-mail of Business Owner*

Mobile Phone Number of Business Owner*

Phone Number

% of Ownership*

Date of Birth of Business Owner*

MonthDayYear

Social Security Number*

Credit Score (Approximately)

Business Description*

Business Website (Optional)

Example: www.jotform.com

Do you rent or own your business space?*

RentMortgage/Owed

Funds Requested*

$ Amount

Use of Funds?*

Total Monthly Sales (all forms of revenue)*

Do you currently have funding from another Lender?*

YesNo

What are the Lender's Names?*

Current Balance?*

I agree that the information herein is true and correct*

Yes

Applicant Signature*

By signing above, each of the above listed business and business owner/officer (individually and collectively, “you”) authorize (AXF Group, LLC dba AX Funding Group ) and each of
its representatives, successors, assigns and designees (“Recipients”) that may be involved with or acquire commercial loans having daily repayment features or purchases of future
receivables including Merchant Cash Advance transactions, including without limitation the application therefor (collectively, “Transactions”) to obtain consumer and/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 (AXF Group, LLC dba AX Funding Group ) to
transmit this application form, 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 (AXF Group, LLC dba AX Funding Group ) and to each of the Recipients, on
its own behalf. I am providing my cellphone number and hereby consent to the receipt of text messages knowing that msg. and data rates may apply. I understand that consent to receive
texts is not a condition of approval. I can expect approx. 10 msgs/month. I/We certify that all the information contained herein is complete, true and accurate.

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Browse Files

Business Funding Application

Owner/Principal Information

Business Information

Financial Information