JVM Capital Secure Application

JVM Capital Factoring Application

We can't wait to fund you
BASIC INFO
Business name*
DBA*
If applicable
Business address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Start Date*

MonthDayYear
Date
Tax ID*
Business Type*

CorporationLLCPartnershipProprietorship

Your Name*

First NameLast Name
Your Title*
Your Phone*
Your Email*
example@example.com

COMPANY OFFICERS
Officer/Owner 1*

First NameLast Name
Officer Title*
Phone*
Home Address*

Street AddressCity, State, Zip
% of Ownership*
Social Security*
Date of Birth*
Drivers License #*
State of license*

Officer/Owner 2

First NameLast Name
Officer Title
Phone
% of Ownership
Social Security
Date of Birth
Home Address

Street AddressCity, State, Zip
Drivers License #

Officer/Owner 3

First NameLast Name
Officer Title
Phone
% of Ownership
Social Security
Date of Birth
Home Address

Street AddressCity, State, Zip
Drivers License #

TELL US ABOUT YOUR CUSTOMERS

Please identify up to three Customers you intend to Factor
Customer #1
Company name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Average Sales per Month

Customer #2
Company name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Average Sales per Month

Customer #3
Company name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Average Sales per Month

Do you or the company have any of the following Loans?

Bank Loan or Revolving Line of CreditPPP LoanEIDL Loan7A Loan504 LoanMCA (Merchant Cash Advance) or Working Capital Loans
Total Amount of Any of the Loans Above:

SUPPORT DOCUMENTS

Please upload the following forms
3 Months Business Bank Statements (6 Months for Payroll Funding Only)

Cancelof
Please check the box if you do not have the above documents

I do not have

Company Financials (Current Balance Sheet, and P&L)

Cancelof
Please check the box if you do not have the above documents

I do not have

Current AR & AP Aging Reports

Cancelof
Please check the box if you do not have the above documents

I do not have

Last 6 Months of Payroll Reports (Payroll Funding Only)

Cancelof
Please check the box if you do not have the above documents

I do not have

Company Filing Documents, and Owners Drivers License, Resumes (If Available)

Cancelof
Please check the box if you do not have the above documents

I do not have

Invoices for Factoring and Underlying Contracts (MSAs & POs)

Cancelof
Please check the box if you do not have the above documents

I do not have

BRIEFLY DESCRIBE THE NATURE OF YOUR PRODUCT OR SERVICE:

Signature*

Clear
Applicant acknowledges that the above information and documentation will be retained by JVM Capital Ltd. ("JVM"). Applicant hereby asserts that the information contained in this application is true and correct, and Applicant hereby authorizes JVM, its associates, agents, and/or affiliated companies to perform any credit investigation on Applicant, individually, and/or Applicant’s business or businesses, company or companies, including any associated principals, which JVM deems necessary. Applicant agrees to reimburse JVM for all costs and expenses that JVM may incur during the application process and hereby authorizes JVM to file the appropriate UCC financing statements to secure Applicant’s indebtedness.

Phone: (303) 945-9470
www.JVMCapital.com
Copyright 2020 JVM Capital | All Rights Reserved
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