Broker Form

Broker Application Form

To be filled in by the Broker, clients will have a separate form to fill in.
Is this your first time filling up this form?*

YesNo
Broker Name*

First NameLast Name
Brokerage Firm*
Website*
Broker Email*
example@example.com
Case Information

Details of the client you would like to refer to Choco Up for funding assessment
Company Director Name*

First NameLast Name
Company Name*
Website*
Contact Email*
example@example.com
Where is {companyName} incorporated in?*

SingaporeHong KongAustraliaMalaysiaOther
Currency*
How much funding is {companyName} seeking?*
We typically fund 1.0x monthly revenue, minimum USD 10k and maximum USD 1M.
Kindly upload a copy of {companyName} business card (if any)

Please skip if not applicable.
Cancelof
Kindly provide the incorporation documents for the {companyName} and its subsidiaries (if any).*

ACRA, NAR1, etc
Cancelof
Kindly provide the credit report of {companydirectorname}.

CBS, CTOS, etc
Cancelof
Kindly provide the last 12 months bank statements for ALL bank accounts of {companyName}*

If the business has been operating less than 12 months, please upload all the bank statements you have to date.
Cancelof
Kindly provide any other relevant documents for our review (if applicable)

Cancelof
I, {brokerName}, affirm that I have read and understood the contents of this “Declaration Form” and that I am authorized to provide this information on behalf of {companyName}, and I hereby confirm all information provided in this form is true, accurate, and complete to the best of my knowledge and belief. I understand that any misrepresentation, discrepancy, misstatement, dishonesty or deliberate omission of information may constitute fraud.

I further acknowledge that by submitting this declaration, I am providing consent to Happy CP Company Limited and its affiliates to verify the information provided and conduct necessary due diligence, including but not limited to any applicable kinds of background checks and verification of legal proceedings.
Should be Empty:

Broker Application Form

Case Information