BUSINESS FUNDING: INTAKE FORM

Business Funding - Intake Form
Please have the following available BEFORE proceeding with application:

1. Physical Photo Identification (Front and Back)

2. Social Security Card

3. Proof of Residence (EX: Utility Bill, Rent/Lease Agreement, etc.)

4. Credit Score on: Experian, Tranunion, and Equifax (If you are not sure on your personal credit score please visit http://emisonscore.com to get all 3 scores.)

5. Business EIN Certificate

6. Business Articles of Organization

7. Business Bank Statment (MOST RECENT 3 statements)

8. PayStub (MOST RECENT 2 statements)

9. Business Tax Return (If available - MOST RECENT 2 years)

10. W2 (If available - MOST RECENT 2 years)

Personal Information:
Date

MonthDayYear
Date
Referral
Name

PrefixFirst NameLast Name
Mother's Maiden Name
Date of Birth

MonthDayYear
Date
Place of Birth
Phone Number
Social Security Number (SSN)
Personal Email
example@example.com
Residence Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
I currently:

Own the property I reside in.Rent the property I reside in.
What is the monthly Mortgage/Rental Payment?

Credit Score Information:

If you are not sure on your personal credit score please visit http://emisonscore.com to get all 3 scores.
Experian Personal Credit Score
Transunion Personal Credit Score
Equifax Personal Credit Score
Credit Report Log-in Information
Please list the following: Email, Password, PIN, and Security Question(s).

Employment Information:
Employment Status:

Self-EmployedEmployedUnemployed
What is your job position/designation?
Who is your employer?
Annual Income:

Business Information:
Business Legal Name
Business DBA Name (If applicable.)
Business Website URL
Business Description
Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Business Entity Type
Employer Identification Number (EIN)
Business Email
example@example.com
Business Formation Date

MonthDayYear
Date

Funding Information:
Funding Amount Requested
Purpose For Funding
Line of Credit
Personal Credit Cards
Hard Cash
Current Business Credit Cards
Current Bank Relationships
Current Business Bank Accounts

Personal Supplemental Information:
Identification (Physical State ID only - Front)

PLEASE TAKE A PICTURE OF FRONT OF ID.
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Identification (Physical State ID only - Back)

PLEASE TAKE A PICTURE OF BACK OF ID.
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Identification (Clear Picture of SELF w/ ID)

PLEASE TAKE A PICTURE OF YOURSELF HOLDING YOUR ID NEXT TO YOUR FACE. MAKE SURE YOU HAVE GOOD LIGHTING TO SHOW YOUR FACE MATCHING THE ID.
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Social Security Card

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Proof of Residence

(EX: Utility Bill, Rent/Lease Agreement, etc.)
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Recent Paystub(s)

PLEASE INCLUDE: 2 MOST RECENT PAY STUBS.
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W-2 Forms

PLEASE INCLUDE: 2022 AND 2023 W-2 FORMS.
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Personal Tax Returns

PLEASE INCLUDE: 2022 AND 2023 BUSINESS TAX RETURNS.
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Credit Report

EX: Experian, Equifax, TransUnion, etc.
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Business Supplemental Information:
Business Tax Returns

PLEASE INCLUDE: 2022 AND 2023 BUSINESS TAX RETURNS.
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Corporate State Articles of Organization

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Corporate State Good Standing

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EIN Letter

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Business Bank Statement

PLEASE INCLUDE MOST RECENT 3 MONTHS OF YOUR BUSINESS BANK STATEMENT(S).
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Credit Authorization:
This agreement ("Agreement") is made effective as of Date , by and between Blaec Elite Funding Group ("The Company") and {name} ("Client").

Client Information:
- Full Name: {name}
- Date of Birth: {dateOf}
- Social Security Number: {phoneNumber13}
- Address: {residenceAddress}
- Phone Number: {phoneNumber}
- Email: {personalEmail}
Authorization and Purpose

By signing this Credit Authorization Form, I, the undersigned business owner or authorized representative, hereby authorize TBD (the "Company") to obtain, review, and analyze the business’s and personal credit information for the purpose of evaluating and securing a business funding loan.
This authorization specifically includes:
- Pulling credit reports related to the business and personal credit of the business owner(s) from relevant credit reporting agencies.
- Communicating with lenders, financial institutions, or other third parties as necessary to facilitate the funding process.
- Using the gathered credit information to assist in obtaining approval for funding.
Authorization to Obtain Credit Information

I authorize the Company to act on behalf of the business to retrieve credit reports and any related credit information from both business and personal credit reporting agencies, including but not limited to Dun & Bradstreet, Equifax, Experian, and TransUnion. This information will be used exclusively to assess the business's eligibility for loan products and funding opportunities.
This authorization shall remain effective until the business funding process is completed or the agreement between the business and the Company is terminated, unless otherwise revoked in writing by the undersigned.

Use of Information

The Company will use all credit and financial information solely for the purposes of evaluating loan options and securing business funding. The Company agrees to handle all data with strict confidentiality and in accordance with applicable privacy laws, including the Fair Credit Reporting Act (FCRA).

Client Acknowledgment

I acknowledge that I am voluntarily providing this authorization and that TBD has informed me of my rights under the Fair Credit Reporting Act. I understand that the credit information retrieved will be used solely for business loan evaluation purposes and that the Company does not guarantee loan approval or specific loan terms.

Signature

By signing below, I confirm that I have the authority to act on behalf of the business and agree to the terms of this Credit Authorization Form. I grant permission to TBD to access and use my business and personal credit information as outlined.

Signature

Client Agreement:
This agreement ("Agreement") is made effective as of Date* , by and between Blaec Elite Funding Group ("Service Provider") and {name} ("Client").

Requested Funding Amount: {fundingAmount}

Business Information:
- Business Name: {businessLegal}
- Owner/Authorized Representative: {name}
- Business Address: {businessAddress}
- Tax ID (EIN): {employerIdentification}
Agreement Terms

By executing this Agreement, the undersigned ("Client") hereby requests that TBD ("Company") provide assistance in procuring business funding on behalf of the Client.
The Client acknowledges and agrees that the Company shall utilize the information provided by the Client, as well as any additional information obtained during the course of the funding process, to perform necessary due diligence in evaluating the Client’s eligibility for financing. The Client further acknowledges that while the Company will endeavor to secure the requested funding, the Company makes no warranties, representations, or guarantees regarding the approval of the funding application or the amount of funding that may ultimately be offered.
In the event that additional information or documentation is required to proceed with the funding process, the Client agrees to furnish such information promptly upon request. The Client understands that communication regarding the status of the funding request will be provided by the Company as updates become available.

Signature Terms

By executing this Agreement, the Client further acknowledges and agrees that:
- The Client has reviewed, understood, and accepts the terms and conditions set forth in this Agreement.
- The Client is responsible for providing accurate and complete information for the purposes of the funding application.
- The Company does not guarantee funding approval, and the Client will be contacted in the event that additional information or documentation is required to facilitate the funding process.
- The Client agrees to await communication and updates from the Company regarding the status of the funding application.
Client Signature

{name} Signature*

Disclaimer and Waiver
By proceeding with this application, you authorize BEFUND and our affiliates to perform a soft credit inquiry to assess your credit profile. A soft pull does not impact your credit score, and it is used solely for informational purposes to evaluate your eligibility for financing. BEFUND values your privacy and ensures that all information obtained is handled securely and in compliance with applicable regulations. This credit check is intended to support our efforts in providing you with tailored financing solutions. By agreeing to this process, you acknowledge and consent to the soft inquiry, understanding it is a preliminary step in determining eligibility and does not obligate you to accept financing.

Signature
First Name Last Name
Should be Empty:

Business Funding - Intake Form

Personal Information:

Credit Score Information:

Employment Information:

Business Information:

Funding Information:

Personal Supplemental Information:

Business Supplemental Information:

Credit Authorization:

Client Information:

Authorization and Purpose

Authorization to Obtain Credit Information

Use of Information

Client Acknowledgment

Signature

Client Agreement:

Business Information:

Agreement Terms

Signature Terms

Client Signature

Disclaimer and Waiver