MCA Application Form

Application Form
BUSINESS INFORMATION
Legal Business Name
DBA (Doing Business As)
Company's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Business Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Business Email Address
example@example.com
When was your business incorporated?
Business Number
Business Website
Business Industry
Entity Type

Other
Number of Employees
Business Property is
Monthly Rent
Landlord's Name

First NameLast Name
Landlord's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Property Value
Mortgage Balance

SIGNATURE
SIGNATURES – ALL OWNERS MUST SIGN – By signing below, the Client and its owner(s) certify that all information and documents submitted in connection with this Application are true, correct and complete. Additionally, the owner(s) authorize Swift Bridge Funding or any of its agents, partners, and affiliates to contact the above landlord, supplier, and emergency contacts, as well as obtain and use business and non-business consumer credit reports from credit reporting agencies and any other information regarding the Client and its owner(s) from third parties, both at the time of the initial funding application and at any time after the Client has received funding as long as the Merchant remains a client of Swift Bridge Funding. At all times, Swift Bridge Funding will comply with the personal information collection, protection, use, sharing, and retention practices set out in the Privacy Policy *
Owner's Signature