Lightning Funding Solutions
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Legal/Corporate Name
DBA
Business Address
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Business Phone
*
Please enter a valid phone number.
Business Email
example@example.com
Federal Tax ID
*
Date Business Started
-
Month
-
Day
Year
Date
Type of Entity
Limited Liability corporations (LLC)
Sole Proprietorship
C-corporation
S-corporation
General partnership
Independent contractor (1099)
Other
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Primary Owner Information
Owner Name
*
First Name
Last Name
Ownership Percentage
*
Email
example@example.com
Cell Phone
Please enter a valid phone number.
SSN
*
Date of Birth
*
-
Month
-
Day
Year
Date
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Business Core Information
Any Tax Liens
Yes
No
Any bankruptcies
Yes
No
Are you currently paying off any loans or advance(s)
Yes
No
Avg Monthly Gross Sales Volume?
Requested Funding Amount
What Will Funds Be Used For ?
*
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Signature & Consent
Primary Owner Signature
*
Please Upload Recent Bank Statement.
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