WORKING CAPITAL - APPLICATION FORM

GOLDENCAP
Hi!

Congrats! in taking your first step for applying for working capital for your business.

Please fill in the form below usually only takes less than 5-10 minutes to fill out. Also send 3 recent business bank statements to this email: support@goldencap.io By signing below, you certify that all information and documents submitted in connection with this application are true, correct, and accurate. Incomplete applications will not be processed.
Business Legal Name
Doing Business As (Dba)
Business Address
Business Phone
Mobile
Please enter a valid phone number.
Website
Email
example@example.com
State of Organization
Federal (Tax ID)
Business Start Date

MonthDay Year
Date
Date Current Ownership Started

MonthDay Year
Date
Monthly Rent/Mortgage Payment
Landlord Name
Landlord Phone
Remaining length of lease
Owner/Principal Information (Owner 1)
Name
Date of Birth

MonthDay Year
Date
Home Address
Email
example@example.com
% of Ownership
SSN #
Owner/Principal Information (Owner: 2)
Name
Date of Birth (DD/MM/YYYY

MonthDay Year
Date
Home Address
Email
example@example.com
% of Ownership
SSN #
Industry Description/SIC
Type of product/service sold
Annual Business Revenue
Average Monthly Sales
Average Monthly Credit Card Sales
Current working capital balance
Purpose of Funds Requested
Authorizations: By signing below, each of the above listed business and business owners (individually and collectively, "you") authorize Goldencap, LLC ("GOLDENCAP") and its affiliates, successors, assigns and designees ("Recipients") to obtain consumer, personal and business reports and other information about you, including credit card processor statements and bank statements, from one or more consumer reporting agencies, such as TransUnion, Experian and Equifax, and from other credit bureaus, banks, creditors and other third parties. You also authorize GOLDENCAP to transmit this Application, along with any information obtained in connection with this Application, excluding consumer credit reports, to any or all of the Recipients.
Owner 1 Signature

Clear
Date

MonthDay Year
Date
Should be Empty:

GOLDENCAP