Merchant Application
Please complete all required fields.
Which service(s) are you interested in?
*
Cash Advance
Credit Card Processing
Equipment Financing
Payment Gateway
Business Legal Name:
*
Business DBA Name:
*
Type of Business Entity (Check One):
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Corporation
LLC
Partnership
Sole Proprietor
Other
Industry Type:
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Requested Amount
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Average Monthly Volume
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Do you have any existing MCA loans?
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Yes
No
What is your current balance(s)?
State of Incorporation:
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Use of Proceeds:
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Business Start Date:
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Month
-
Day
Year
Date
Federal Tax ID:
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Business URL
Credit Rating:
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Excellent
Good
Fair
Bad
Business Address:
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Street Address
Suite/Unit/Apt
City
State / Province
Postal / Zip Code
Business Phone
*
Please enter a valid phone number.
Preferred Contact Phone
*
Please enter a valid phone number.
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Owner Details
Owner #1:
*
First Name
Last Name
Mobile Phone:
*
Please enter a valid phone number.
Owner #1 Email:
*
example@example.com
Job Title:
*
Ownership %:
*
Social Security:
*
Format: 123-45-6789
Date of Birth:
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-
Month
-
Day
Year
Date
Owner #1 Home Address:
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Street Address
Suite/Unit/Apt
City
State / Province
Postal / Zip Code
Has Owner #1 filed Bankruptcy?
*
Yes
No
If yes, has it been discharged?
Yes
No
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Owner Details Cont.
Owner #2:
First Name
Last Name
Mobile Phone:
Please enter a valid phone number.
Owner #2 Email:
example@example.com
Job Title:
Ownership %
Social Security:
Format: 123-45-6789
Date of Birth:
-
Month
-
Day
Year
Date
Owner #2 Home Address:
Street Address
Suite/Unit/Apt
City
State / Province
Postal / Zip Code
Has Owner #2 filed Bankruptcy?
Yes
No
If yes, has it been discharged?
Yes
No
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Authorizations / Signatures
By signing below, each of the above listed business and business owner(s)/officer(s) (individually and collectively, "you") authorize [Funds 4 All, LLC] "F4A" and each of its representatives, successors, assigns and designees ("Recipients") that may be involved with or acquire commercial loans having daily repayment features or purchases of future receivables including Merchant Cash Advance transactions, including without limitation the application therefor (collectively, "Transactions") to obtain consumer or personal, business and investigative 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 F4A to transmit this application form, along with any of the foregoing information obtained in connection with this application, to any or all of the Recipients for the foregoing purposes. You also consent to the release, by any creditor or financial institution, of any information relating to any of you, to F4A and to each of the Recipients, on its own behalf.
Owner #1 Signature:
*
Owner #2 Signature:
Owner #1 Name:
*
Owner #2 Name:
Date:
*
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Month
-
Day
Year
Date
Date
-
Month
-
Day
Year
Date
Upload Supporting Documents (FASTER PRE-APPROVAL):
Browse Files
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Drivers License, Voided Check, Last 4 Month Business Bank Statements (PDF, JPG, JPEG, PNG)
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