INTEGRATED BUSINESS FINANCING-Business Financing Application JF

INTEGRATED BUSINESS FINANCING

BUSINESS FINANCING APPLICATION
Business Legal Name*
Doing Business As
Federal Tax ID*
Business Phone*
Business Website
Best Contact Number*
Business Fax
Email Address*
example@example.com
Business Start Date*

MonthDayYear
Date
Physical Address*

Physical Address

Street Address Line 2

CityState

Zip Code
Mailing Address (If Different)

Mailing Address

Street Address Line 2

CityState

Zip Code
Name*
% of Ownership*
Email*
example@example.com
Address*

Home Address

Street Address Line 2

CityState

Zip Code
Mobile*
Date of Birth*

MonthDayYear
Date
Social Security #*
2nd Owner/ Principal Information
Name
%of Ownership
Address

Home Address

Street Address Line 2

CityState

Zip Code
Email
example@example.com
Mobile
Date of Birth

MonthDayYear
Date
Social Security #
Business Description*
Renter or Owned*
Open Bankruptcy?*
Rent/Mortgage Amount
Landlord/Mortgage Company Contact
Gross Annual Sales (Last Year's Tax Return)*
Visa/MasterCard Monthly Volume:
Total Monthly Sales (All Forms of Revenue):*
How Much Capital is Being Requested*
Desired Use of Funds*
Do you currently have a Cash Advance? If Yes, what is the Current Outstanding Balance?
The Merchant and Owner(s)/Officer(s) identified above (individually, an "Applicant") each representative, acknowledges and agrees that (1) al information and documents provided to Integrated Business Financing including credit card processor statements are true, accurate and complete, (2) Applicant will immediately notify Integrated Business Financing of any change in such information or financial condition, (1) Applicant authorizes integrated business Financing to disclose all information and documents that integrated Business Financing may obtain including credit reports to other persons or entities (collectively. that may be involved with or acquire commercial loans having dally repayment features or purchases of future receivables including Merchant Cash Advance transactions, including without Limitation the application therefor (collectively, "Transactions"), and each Assignee authorized to use such information and documents, and share such information and documents with other Assignees, in connection with potential Transactions, (4)Integrated business Financing and each Assignee will rely upon the and completeness of such information and documents (5)integrated Business Financing Assignees, and each of their integrated Business Financings successors assignees and Designees (collectively. "recipients") are authorized to request and receive any investigative reports, credit reports, statements from creditors or financial institutions verification of information or any other information that Recipient deems necessary of Applicant waives and releases any claims against recipients and any information providers arising from any act or omission relating to the requesting receiving or release of information and (7) each Owner/Officer represents that he or their authorized to sign this form on behalf of Merchant A copy of this authorization may be accepted as an original The term "Integrated Business Financing” shall mean any representative providing funding sources and looking to offer, make of provide to the Merchant access to loans or merchant cash advances based on Merchant's future receivables or sales and/or structured with a periodic repayment feature.
Owner Signature*

Clear
Print Name*
Date*

MonthDayYear
Date
Co Owner Signature

Clear
Print Name
Date

MonthDayYear
Date
"Note:All Fields Are Required on this Application before Submission.
Should be Empty: