Business Funding Application

Business Funding Application
Sapphire Consultants

350 West 45th St Suite 2A

New York, NY 10036

929-409-3580

www.sapphire-consultants.com
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*

MonthDayYear
Date
Business Address*

Street Address

Street Address Line 2

CityState

Zip Code
Owner/Principal Information
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*
Business Information

Please answer a few basic questions about your business.
Business Description*
Do you rent or own your business space?*

RentMortgage/Owed
Financial Information

Loan Details
Use of Funds?*

Purchase InventoryCover PayrollBuy EquipmentHire More StaffExpansionMarketingManage Cash FlowOther
Total Monthly Sales (all forms of revenue)*

$5,000-$10,000$10,001-$25,000$25,001-$50,000$50,001-$100,000$100,000 or more
Do you currently have funding from another Lender?*

YesNo
What is the Lender's Name?*
Current Balance?*
Approx. FICO Credit Score*
Total funding amount requested*
I agree that the information herein is true and correct*

Yes
Applicant Signature*
By clicking submit, Applicant expressly consents and authorize Sapphire Consultants LLC to call, send text messages, and/or send other electronic messages (including prerecorded or artificial voice messages) using an automatic telephone dialing system to any telephone number provided by Applicant, and any telephone number included in any and all applications or any administrative form, including cellular phone numbers and landlines, regardless of their inclusion on any do not call list, for purposes of servicing, collections, marketing or promoting any product offered by Sapphire Consultants LLC. Please note that you are not required to consent to be called for marketing or promotional purposes in order to qualify for financing or obtain any other products or services from Sapphire Consultants LLC. If you do not agree to be called for marketing or promotional purposes please call 929-409-3580 or email lance@sapphire-consultants.com
Upload Last 3 months business bank statements or email

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Business Funding Application

Owner/Principal Information

Business Information

Financial Information