General - The NexGen Lending

Business Information
Business Name:DBA
Business Legal Name*
Business Start Date*

MonthDayYear
Business Federal Tax ID#*
State Of Incorporation:*
Entity Type
Industry:*
Business Email Address:*
Business Phone Number*
Please enter a valid phone number.
Business Website:
Business Address*

Street Address

CityState

Zip CodeCountry

Business Finance
Amount Requested:*
Use of Funds:*
Annual Business Revenue:*
We use this to determine your overall business performance.
Any Outstanding Balances?*

YesNo
Initial Funded Amount
Name of Initial Lending Company
What is current loan balance?
If unknown, please type N/A

Primary Business Owners
Business Owner Name:*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email Address*
example@example.com
Date of Birth:*

MonthDayYear
Date
SSN*
We will use your Social Security Number to help confirm your identity and conduct a credit inquiry. Applying will not impact your personal credit score.
Credit Score*
Home Address*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Business Ownership%*
How much of the business do you own?
Is There A Secondary Owner?*

YesNo
Secondary Business Owners
Business Owner Name:*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email Address*
example@example.com
Date of Birth:*

MonthDayYear
Date
SSN*
We will use your Social Security Number to help confirm your identity and conduct a credit inquiry. Applying will not impact your personal credit score.
Credit Score*
Address*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Business Ownership%*
How much of the business do you own?
Last meal on earth, what food is on your plate?
Last meal on earth, what food is on your plate?
What is your favorite sport & sports team?
What is your favorite hobby?
What is your favorite book or movie?

UPLOAD THE FOLLOWING REQUIRED DOCUMENTS

Upload your last 4 months of most recent business banking statements in addition to your “month to date” for the current month in PDF format. This is mandatory, if issues uploading please contact your representative directly. (PDF FILE ONLY)
Once terms are fully agreed on, we do require a copy of your driver’s license & a voided check from the business. Please attach in the drop down below if readily available. If you have any “Zero Balance Letters” or “necessary” documents please attach in the additional documents section below.
Upload "Month to Date" for Current Month Here (PDF FILE ONLY)

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Upload Business Bank Statements #1 Here (PDF FILE ONLY)

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Upload Business Bank Statements #2 Here (PDF FILE ONLY)

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Upload Business Bank Statements #3 Here (PDF FILE ONLY)

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Upload Business Bank Statements #4 Here (PDF FILE ONLY)

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Upload “Month to Date” for Current Month (PDF FILE ONLY) [If trouble uploading, contact your representative for assistance]

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Driving License

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Voided Check

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Add Additional Documents (If Any)

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PLEASE READ AND SIGN BELOW TO SUBMIT FOR FUNDING
By signing, faxing or emailing us your application, you certify that (i) you are authorized to apply on behalf of the company whose full legal name appears above under the company information portion of the cash advance application for working business capital from us and (i) all information you provide within the application and other supporting documents is true and complete and that you will notify us of material changes to such information. You understand & agree that we and our agents, representatives, and assignees are authorized to contact 3rd parties to make inquires in evaluating your application (including requesting and obtaining business & personal credit bureau reports from credit from credit reporting agencies and other sources) or for any update, renewal, extension of credit bureau name and address. You understand and agree that we may provide credit & other information from the application and on the signing individual(s) & the company with 3rd parties who may use the information any lawful purpose, including for the purpose of offering credit and/or other products & services to signing individual(s) and/or the company. To help the government fight the funding of terrorism and money laundering activities Federal law requires us to obtain, verify, and record information that identifies each person who cashes checks, wire funds or engages another financial services with SRJ Marketing INC dba NexGen Lending. We will ask for your name, address and other information that will allow us to identify you. We may also ask to see your driver's license or other identifying documents.

By clicking here, you can view our TCPA consent to place marketing calls form. Please click this link to navigate through the guidelines provided directly from the Telephone Consumer Act (47 U.S.C § 227)
Consent*

By checking this box, I consent to receive SMS messages. I understand that Message and data rates may apply and that I may reply STOP to opt-out of future messaging; reply HELP for additional messaging help. Message frequency may vary depending on interaction between you and our agents.By providing my contact information to NexGen Lending, I acknowledge and give my explicit consent to be contacted via SMS and receive emails for various purposes, which may include marketing and promotional content. Message and data rates may apply. Message frequency may vary. Reply STOP to optout. Refer to our Privacy Policy for more information. By submitting this application, I consent to receive and sign all required documents electronically. I understand that electronic signatures and documents are legally binding in accordance with the Electronic Signatures in Global and National Commerce (E-Sign) act. I consent to receive and interact with NexGen lending & all of its affiliates electronically.
Owner 1 Signature*

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Owner 2 Signature

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Today's Date*

MonthDayYear
Date
Today's Date

MonthDayYear
Date
Should be Empty:

Business Information

Business Finance

Primary Business Owners

Secondary Business Owners

UPLOAD THE FOLLOWING REQUIRED DOCUMENTS

PLEASE READ AND SIGN BELOW TO SUBMIT FOR FUNDING