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NATIONALMCA.COM - Business Application
SPHYNX CAPITAL HOLDINGS LLC
Office: (833) FUND-NYC (386-3692) I Fax: (833) FUND-NYC Email: NEWAPP@NATIONALMCA.COM
BUSINESS INFORMATION
The Business DBA Name
Corporation Name
Federal ID
Type of Business
Business Address
SuiteOffice
City
State
ZIP Code
Work Phone
Cell Phone
Fax
Email
example@example.com
Business Website
Product Sold
Years in Business
Gross Annual Sales
Monthly Rent or MTG Payment
Term on Lease
Do you have a cash advance now?
With Whom
Balance
OWNER INFORMATION - NATIONALMCA.COM
Owner Full Name
of Ownership
SS
Drivers License
Personal Credit Score
Home Address
City
State
ZIP Code
Home Phone
Personal Email
example@example.com
Years at Current Address
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NATIONALMCA.COM - Business Application

CO-APPLICANT INFORMATION . NATIONALMCA.COM
CoOwner Full Name
of Ownership
SS
Drivers License
Personal Credit Score
Home Address
City
State
ZIP Code
Home Phone
Personal Email
example@example.com
Years at Current Address
CURRENT MERCHANT CASH ADVANCES
(Please list all current loans you have outstanding with estimated balances)
1st Position Company
Balance
Daily or Weekly Payment
2nd Position Company
Balance
Daily or Weekly Payment
3rd Position Company
Balance
Daily or Weekly Payment
LANDLORD INFORMATION - NATIONALMCA.COM
Company Name
Contact Name
Address

Address

Street Address Line 2

CityState

Postal / Zip Code
Phone Number
Email Address
example@example.com
TRADE REFERENCES
Trade Reference 1 Co
Contact Name
Phone
Trade Reference 2 Co
Contact Name
Phone
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NATIONALMCA.COM - Business Application
Trade Reference 3 Co
Contact Name
Phone
AUTHORIZATION
By signing below, each of the above listed business and business owner/officer (individually and collectively, "you") authorize NATIONALMCA.COM, CHATMCA.COM, and SPHYNX CAPITAL HOLDINGS LLC and each of its representatives, successors, assigns, affiliates, partners, investors, funding sources, and designees ("Recipients") that may be involved with or acquire commercial loans having daily repayment features or purchases of future receivables including Merchant Cash advance transactions, including without limitation the application therefor (collectively, "Transactions") to obtain, use, store, share, transmit, analyze, process, and utilize in any manner whatsoever, without limitation, any and all consumer and/or personal, business and investigative reports and other information about you, including but not limited to credit card processor statements, bank statements, financial records, business records, personal records, contact information, and any other data or information, from one or more consumer reporting agencies, such as TransUnion, Experian and Equifax, and from other credit bureaus, banks, creditors, processors, and any other third parties. This authorization grants unlimited rights to use, compress, store, transmit, and utilize all such information for any business purposes, marketing, underwriting, collections, legal proceedings, and any other purposes whatsoever, now and in the future, without restriction or limitation. You also authorize NATIONALMCA.COM to transmit this application form, with any of the foregoing information obtained in connection with this application, to any or all of the Recipients for any purposes whatsoever. You also consent to the release, by any creditor or financial institution, of any information relating to any of you, to NATIONALMCA.COM and to each of the Recipients, on its own behalf, without limitation. I am providing my business cell phone and business e-mail address and hereby consent to the receipt of unlimited correspondence/messages regarding transactions with NATIONALMCA.COM and/or its affiliates on any medium. I also hereby consent to the receipt of text messages knowing that msg. and data rates may apply. I understand that consent to receive texts is not a condition of approval. I can expect unlimited msgs. I/we certify that all the information contained herein is complete, true and accurate.
EXCLUSIVITY AGREEMENT
By submitting this application, you acknowledge and agree that you are entering into an exclusive relationship with SPHYNX CAPITAL HOLDINGS LLC, NATIONALMCA.COM, and CHATMCA.COM for a period of sixty (60) days from the date of this application submission. During this exclusive period, you agree that you will not apply for, solicit, accept, or enter into any funding agreements, merchant cash advances, business loans, or any other form of business financing from any other lender, broker, or funding source. This exclusivity period shall remain in effect for the full 60 days unless and until you receive and accept a funded offer from us. You acknowledge that this exclusivity agreement is a material condition of our review and consideration of your application. Any violation of this exclusivity provision may result in immediate termination of your application and potential legal remedies.
Loan amount youre requesting include the amount to be paid off from your existing loanadvance
Signature

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Title
Date

MonthDayYear
Date
Signature

Clear
Title
Date

MonthDayYear
Date
IMPORTANT: COMPREHENSIVE DATA AUTHORIZATION & EXCLUSIVITY TERMS
UNLIMITED DATA USAGE AUTHORIZATION: By signing this application, you grant SPHYNX CAPITAL HOLDINGS LLC, NATIONALMCA.COM, CHATMCA.COM, and all affiliated entities unlimited, perpetual, irrevocable rights to collect, use, store, process, analyze, share, sell, transmit, and utilize in any manner whatsoever all information provided herein and any information obtained about you or your business from any source. This includes but is not limited to: financial data, bank statements, credit reports, business records, personal information, contact information, processor statements, tax returns, and any other data or documentation. You acknowledge that this data may be used for underwriting, marketing, collections, legal proceedings, business development, analytics, and any other purposes deemed appropriate by the company, without limitation or restriction, now and in perpetuity. BINDING EXCLUSIVITY COMMITMENT: You acknowledge and agree that by submitting this application, you are bound by an exclusive 60-day commitment period during which you may not seek, apply for, accept, or enter into any alternative financing arrangements with any other party. This exclusivity period is non-negotiable and binding regardless of our decision on your application. Any violation of this

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NATIONALMCA.COM - Business Application exclusivity provision may result in legal action and damages. ACKNOWLEDGMENT: I/We have read, understood, and agree to all terms stated herein, including the unlimited data usage authorization and binding exclusivity commitment.
Applicant Signature

Clear
Print Name
Date

MonthDayYear
Date
CoApplicant Signature

Clear
Print Name
Date

MonthDayYear
Date
CREDIT INFORMATION
Permission is also granted to contact any business past, present or future, we may deal with including Banks, Landlord, and Insurance companies we currently use or will use in the future. By my signature below, I certify the information I provided on this form is true and correct. Applicant(s) named above hereby authorizes NATIONALMCA.COM, CHATMCA.COM, and SPHYNX CAPITAL HOLDINGS LLC, its affiliates, assigns, agents, banks, financial institutions, funding sources, investors, and any other parties to obtain, use, store, share, analyze, process, and utilize without limitation any credit reports, investigation reports, financial data, personal information, business information, and any other information or data with information submitted by applicant for any purposes including but not limited to obtaining a working capital advance, marketing, collections, legal proceedings, and any other business purposes whatsoever. I/We grant our complete and irrevocable permission to release, use, and share our confidential information to NATIONALMCA.COM and/or its affiliated companies, funding sources, and any other parties for any purposes without restriction. I/We understand this information may be used for credit underwriting, marketing, business development, collections, legal proceedings, and any other purposes they deem appropriate. I agree that this Disclosure and Authorization form in original, faxed, photocopied or electronic (including electronically signed) form, will be valid for any reports, information gathering, or data usage that may be requested by or on behalf of the Company or any affiliated parties, now and in the future, without limitation. This authorization shall remain in effect indefinitely unless revoked in writing, and shall survive any funding or rejection of this application. Confirmation of credit checks processed may be confirmed by calling (833) FUND-NYC (386-3692

By signing below, you reconfirm your agreement to the 60-day exclusivity period with SPHYNX CAPITAL HOLDINGS LLC, NATIONALMCA.COM, and CHATMCA.COM as detailed above, and acknowledge that this exclusivity provision is binding and enforceable.
If yes how much
Bankruptcy in the last 12 months?
If yes date of discharge

MonthDayYear
Date
Signature

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Title
Date

MonthDayYear
Date
Print Name
CO-OWNER
If yes how much
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Bankruptcy in the last 12 months?

NATIONALMCA.COM - Business Application If yes, date of discharge?
If yes date of discharge

MonthDayYear
Date
Signature

Clear
Title
Date

MonthDayYear
Date
Print Name
SPHYNX CAPITAL HOLDINGS LLC
Office: (833) FUND-NYC (386-3692) I Fax: (833) FUND-NYC Email: NEWAPP@NATIONALMCA.COM

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SPHYNX CAPITAL HOLDINGS LLC

BUSINESS INFORMATION

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CURRENT MERCHANT CASH ADVANCES

TRADE REFERENCES

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AUTHORIZATION

IMPORTANT: COMPREHENSIVE DATA AUTHORIZATION & EXCLUSIVITY TERMS

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CREDIT INFORMATION

CO-OWNER

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SPHYNX CAPITAL HOLDINGS LLC