Iterum Financial Application

Full Legal Name Owner 2
% of Ownership
Home Address Owner 2

Home Address

Street Address Line 2

CityState

Zip
Owner 2 Email
example@example.com
Owner 2 Mobile
Owner 2 Date of Birth

MonthDayYear
Date
Owner 2 Social Security #
SSN
Authorization Form

By signing below, each of the above listed business and business ewner/efficer (individually and ( Eectively, "you") authorize ITERUM FINANCIAL INC and each of its representatives, - cessons, assigns and designees ("Recipiente") that may be involved with or acquire commercial loans having daily repayment features or purchases of feture recrivables including Merchant Cash Advance transactions, indeding without limitation the application therefore (collectively, "Transactions") to obtain consumeror personal, and investigative reports and other information abost yea, including credit card processor statements and bank statements, from one or more consumer reporting agencies, each as Trans Union, Experian and Equifax, and from other credit bureaus, banks, creditors and other third parties.
Owner 1 Name*
Date

MonthDayYear
Date
Owner Signature*

Clear
Owner 2 Name
Date

MonthDayYear
Date
Co Owner Signature

Clear
Should be Empty: