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
City State / Province
Postal / Zip Code

Start Date*

MonthDay Year
Date
Tax ID*
Business Type*

CorporationLLCPartnershipProprietorship

Your Name*

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

COMPANY OFFICERS
Officer/Owner 1*

First Name Last Name
Officer Title*
Phone*
Home Address*

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

Officer/Owner 2

First Name Last Name
Officer Title
Phone
% of Ownership
Date of Birth
Home Address

Street Address City, State, Zip
Social Security
Drivers License #

Officer/Owner 3

First Name Last Name
Officer Title
Phone
% of Ownership
Date of Birth
Home Address

Street Address City, State, Zip
Social Security
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
City State / Province
Postal / Zip Code
Average Sales per Month

Customer #2
Company name
Address

Street Address
Street Address Line 2
City State / Province
Postal / Zip Code
Average Sales per Month

Customer #3
Company name
Address

Street Address
Street Address Line 2
City State / 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

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

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Current AR & AP Aging Reports

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

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Invoices for Factoring and Underlying Contracts (MSAs 7 POs)

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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
Should be Empty:

JVM Capital Factoring Application!

TELL US ABOUT YOUR CUSTOMERS

Customer #1

Customer #2

Customer #3

TELL US ABOUT YOUR COMPANY

SUPPORT DOCUMENTS