Funding Application

Funding Application

Tel: 877-883-8634
COMPANY INFORMATION
Date of application*

MonthDayYear
Date
Legal Name and DBA*
Legal Entity Type*
(LLC, S-Corp, Inc, Sole Prop, etc)
State of Inception*
Business inception Date*

MonthDayYear
Date
Federal Tax ID*
Physical Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone Number*
Please enter a valid phone number.
Business Phone Number*
Please enter a valid phone number.
Business Email*
example@example.com
Has any owner been convicted of a felony?

YesNo
Business Home Based?

YesNo
Rent or Own Location?

RentOwn
Any existing loans?

YesNo
Balance of current loans
Funding Company
Business Bank Name*
Industry Type*
Business Financial Information
Total Sales From Previous Tax Return
Type a question
Average Daily Bank Balance $
Average Monthly Sales $
Total Deposits
Credit Card Processor
Average Monthly Credit Card Sales $
Requested Loan Amount*
Primary Use Of Funds*
Brief description of the type of financing you are seeking:

0/70
OWNER / OFFICER INFORMATION
Full Name*

First NameLast Name
Officer Title*
Ownership %*
Officer Title*
Drivers ID#*
FICO SCORE
Social Security Number*
Date of Birth*

MonthDayYear
Date
Owner Officer 1 Home Address *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Print Name (1)*
Bank Statements

Last 3 months of business bank statements
Cancelof
Drivers License ID

Photo of your state ID
Cancelof
By signing this application, the merchant and its owners/principals certify that all information and documents subminted in the connection with this is true; and authorize Red Rock Lenders LLC, it's agents and lenders to receive credit reports and any other information regarding the merchant and it's owners to verify any information provided in the application.
Signature owner (1)*

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Second Owner/Officer information ( If Owns 50% )
Name

First NameLast Name
Officer Title
Ownership %
Drivers ID#
Social Security Number
Date of Birth

MonthDayYear
Date
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Printed Name (2)
Signature owner (2)*

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Should be Empty:

Funding Application

COMPANY INFORMATION

Business Financial Information

OWNER / OFFICER INFORMATION