Business Funding Application With 15X Financial Solutions.
15X Financial Solutions is a financial wellness agency that helps business owners from various industries access business funding resources, including business loans or lines of credit, business credit development tools, credit monitoring and repair resources, and financial workshops.
Your Business Information
Business Legal Name
Legal Entity (LLC, Corp, Sole Prop)
*
Doing Business As Name (DBA)
*
Business Description
*
Business Start Date
*
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Federal Tax ID or EIN
*
Business Phone
*
Format: (000) 000-0000.
Business Fax Number
Business Website
*
Personal Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Owner/Principal Information
Full Name
First Name
Last Name
Date of Birth
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Mobile (Phone)
Format: (000) 000-0000.
Percentage of Ownership
Email Address
example@example.com
Personal Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
2nd Owner/Principal Information
Are you the ONLY legal owner of your business?
Please Select
Yes
No
Name
Date of Birth
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Mobile (Phone)
Format: (000) 000-0000.
Percentage of Ownership
Email Address
example@example.com
Personal Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Loan & Financial Information
Amount Requesting
*
Use of Proceeds
*
Which is most important to you?
*
Please Select
Amount of Funds
Speed of Funds
Cost of Funds
Total Monthly Sales (All Forms of Revenue)
*
Credit Score Range
*
Please Select
499 or Below
500-599
600-649
650-679
680 or Above
Do you currently have a cash advance? If yes what is your current outstanding balance
*
I Acknowledge
*
By signing below, the merchant and its owners / principles: (1) certify that all information and documents submitted in connection with this application is tru correct, and complete; (2) authorize 15X Financial Solutions its agents, partners, and lenders to pull credit reports and any other information regarding the merchant and its owners and principles from third parties, to verify any information provided on the application; and (3) to receive an occasional promotion or offer by email or fax. By signing below, each of the undersigned individual(s) who is either an officer/director of the business listed above or a principal/owner of same, each in his/her/its individual and personal capacities (individually and collectively, “you”), certify that all information and documents submitted in connection with this application is true, correct and complete. Further, you authorize 15X Financial Solutions. and each of its representatives, successors, assigns, designees and third-party funding partners, which includes lenders and other finance providers with whom 15X Financial Solutions has, or may in the future enter into, commercial-brokerage-financing relationships (collectively, “Recipients”): (1) to request and receive any consumer, business and/or investigative reports about or of you, from one or more consumer and/or business reporting agencies, including but not limited to TransUnion, Experian, and Equifax; (2) to request, receive and/or verify such other information from third parties including but not limited to credit card processor statements and bank statements; (3) to transmit this form, along with any of the foregoing information obtained in connection with this application, to any Recipient and/or third party as provided by law; and (4) to contact you via telephone call, text message, or e-mail, on your cell phone, or at your e-mail address, as either is indicated above or as reasonably and later identified as belonging to you, including through the use of an automated telephone dialing system, with respect to this application and/or future-related commercial-financing opportunities.
Owner #1 Signature
*
Owner #1 Print Name
*
Date
*
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Owner #2 Signature
Owner #2 Print Name
Date Signed (Owner #2)
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit
Should be Empty: