Application Process

Application Process
How Much In Funding Do You Need?*
What Will You Use the Funds For?*
How Soon Do You Need Funds?*
What Is Your Monthly Revenue?*
How'd You Hear About Us?*
Financing Program Wanted?*
Legal Business Name*
DBA Business Name
Name*

FirstLast
Cell Phone Number*
Email*
Address*

Business Street Address

Street Address Line 2

CityState / Province / Region

ZIP / Postal Code
By selecting this option, I agree to receive recurring text messages, emails, and phone calls from Sag Harbor Funding delivered using both traditional and automated means. These communications will be for marketing purposes and personalized promotional updates related to my account, application status, and direct communication regarding my business. Messages will be sent based on my interactions with the application process or as necessary for communication with Sag Harbor Funding agents. I understand that message and data rates may apply and that the frequency of messages will vary based on my account activity. If I decide to no longer receive messages, I can reply 'STOP' to opt out at any time. The use and protection of my data are described in the Privacy Policy and Terms Of Use, which are linked here.

Federal Tax ID Number*
State of Incorporation*
Business Start Date*

MonthDayYear
Legal Business Structure*
Company Website
If no website, leave blank
Industry*
Do you have any business loan balances open with another company?*

YesNo
Principal Owner #1
Address*

Street Address

CityState / Province

Postal / Zip Code
Birth Date*

MonthDayYear
Your Credit Score
Social Security Number*
% Ownership*
Upload Business Checking Account Statements

Required For Approval - Upload Last 3 Months Business Checking Account Statements & a Printout of All Activity for the Current Month Estimated Approval 3 - 4 Hours
Attach 1 Final Business Checking Account Statement Here*

Cancelof
Attach 2 Final Business Checking Account Statement Here*

Cancelof
Attach 3 Final Business Checking Account Statement Here*

Cancelof
Attach 4 Final Business Checking Account Statement Here*

Cancelof
Signature*

Powered by Jotform SignClear
I agree with the terms and conditions of this Disclosure.*

DISCLOSURE The Owner(s)/Officer(s) identified above (individually, an “Applicant”) each represents, acknowledges and agrees that: (1) all information and supporting documents are true, accurate and complete and that you will notify us of material changes to such information (2) Applicant authorizes us to disclose all information and documents that we may obtain including credit reports to other persons or entities (collectively, "Assignees") that may be involved with acquiring business loans having daily, weekly, or monthly repayment features or purchases of future receivables including Merchant Cash Advance transactions and Revenue Based Funding transactions including without limitation the application (collectively, "Transactions"). Each Assignee is authorized to use such information and documents with other Assignees, in connection with potential Transactions, (3) You are authorized to apply on behalf of the company whose full legal name appears above under the Company/Business Information portion of the Application for Transactions. (4) You understand that we and our representatives, 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, verification of references or any other information that a Recipient deems necessary in evaluating your application. (5) 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. (6) You expressly consent to receiving calls including automated dialer calls, SMS messages, faxes, and e-mails from us, our affiliates, and Assignees and you may withdraw your consent by notifying us in writing.
Should be Empty:

Application Process

Principal Owner #1

Upload Business Checking Account Statements