SWIFTLY CAPITAL APPLICATION

SWIFTLY CAPITAL APPLICATION
BUSINESS INFORMATION
LegalCorporate Name
DBA
Address

Physical Address

Street Address Line 2

CityState

Zip
Business Telephone #
Business Fax
Federal Tax ID
Date Business Started

MonthDayYear
Date
Length of Ownership
Website
Type Of Entity? (Corporation, Partnership, LLC, Sole Proprietor)
Email Address
example@example.com
Industry
Product/Service Sold
Owner #1 Information
Corporate Officer/Owner Name
Title
Ownership %
Address

Home Address

Street Address Line 2

CityState

Postal / Zip Code
Zip
Years At Address
SSN
Date of Birth

MonthDayYear
Date
Home #
Cell #
PARTNER INFORMATION
Partner Name
Title
Ownership %
Address

Home Address

Street Address Line 2

CityState

Zip
SSN
Date of Birth

MonthDayYear
Date
Home #
Cell #
BUSINESS PROPERTY INFORMATION
Business Landlord
Contact Name
Phone #
OTHER INFORMATION
Current Cash Advance Company
Balance
Credit Score
Requested Advance Amount
Est Monthly Sales
Permanent US resident?
Applicant authorizes Swiftly Capital LLC, its assigns, agents, banks or financial institutions to obtain an investigative or consumer reportfrom a credit bureau or a credit agency and to investigate the references given on any other statement or data obtained from applicant.
Applicants Signature

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Partners Signature

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Date

MonthDayYear
Date
Date

MonthDayYear
Date
Please Upload Your Last 4 Months Business Bank Statements

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BUSINESS INFORMATION