SBF Funding Application (MCA/LOC)-S

Funding Application

Please fill in the spaces below. You can also Email or Fax us the application. By doing so, you are giving Speedy Holdings Group, Inc. as well as its agents and affiliates, permissions to review your business and personal credit history in order to provide you with a formal funding approval.
Phone Email

332-244-0580 Approvalsdept@speedyhg.com
Business Legal Name*
Business DBA Name*
Address*

Street Address

Suite/Floor

CityState

Zip Code
Phone Number*

Area CodePhone Number
Mobile

Area CodePhone Number
Fax

Area CodePhone Number
Email*
Website
Legal Entity:*

CorporationLLCSole ProprietorPartnership
Business Property?*

OwnRent/Lease
Type of Business*
Monthly Payment
Federal Tax ID# (EIN)*
Date Business Started*

MonthDayYear
Business Start Date
Are you a Home Owner?*

YesNo
Estimated Credit Score*
Have you used a Merchant Cash Advance Before?*

NoYes
Amount Requesting?*
If Yes Please fill out

Company Name

Original Balance

Current BalanceState / Province

Amount Requested?
Loan Type Applying For?*

MCALOC
Owner/Principle Information Owner 2
Name*

First NameLast Name
Name

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Phone Number

Area CodePhone Number
Email*
example@example.com
Email
example@example.com
Percentage of ownership
Percentage of ownership
Date of Birth*

MonthDayYear
D.O.B.
Date of Birth

MonthDayYear
D.O.B.
Social Security #*
SSN# (###-##-####)
Social Security #
SSN# (###-##-####) Please enter N/A if not applicable
Drivers License Information*

D.L. #

D.L. EXP. Date

CityState / Province

Postal / Zip Code
Drivers License Information

D.L. #

D.L. EXP. Date

CityState / Province

Postal / Zip Code
Documents Needed
Please Attach Last 6 Months Bank Statements from your Business Account

Browse Files
If later than the 15th of the current month, attach a Month-to-Date statement as well Cancelof
By signing below, the Merchant and its Owners / Principals certify that all information and documents submitted in connection with this Application are true, correct and complete. Additionally, I authorize the lender or any of its agents, partners, and affiliates to obtain and use non-business consumer credit reports and any other information regarding the Merchant and its Owners and Principals from third parties, to verify any information provided on the Application.
Owner 1*

First NameLast Name
Owner 2

First NameLast Name
Owner 1 Signature*

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Owner 2 Signature

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Special Notes:
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Special Notes:
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Should be Empty:

Documents Needed