Referral Partner Submission
Referral Partner
Broker Full Name
First Name
Last Name
Broker Email Address
example@example.com
Phone Number
Please enter a valid phone number.
Business Info
Please enter information about your referral's business.
Company Name
*
Owner
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Time in business
*
Industry Type
*
Please Select
Trucking
Construction
Restaurant
Medical/Pharmaceutical
Manufacturing
Retail
Agriculture
Education
Telecommunications
Finance and Insurance
Automotive
Hospitality
Wholesale
Other
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DEAL DETAILS
Please enter information about your submission
Estimated FICO score
*
Please Select
580 or below
580-619
620-649
650-699
700+
Requested Funding Amount
*
Type of Funding
*
Equipment Financing
Working Capital/MCA
Business Term Loan
Personal Loan/LOC
EQUIPMENT FUNDING SUBMISSION
Please complete if this is for equipment funding (Be sure to upload the equipment invoice/quote)
Equipment Description
Down Payment Available?
Yes
No
Total Equipment Cost
WORKING CAPITAL/MCA FUNDING
Please complete if this is for working capital funding. Make sure to include business bank statements.
Does merchant have any existing working capital/mca debt?
Please Select
Yes
No
If yes, what are the Funder names and balance of any open MCA debt?
BUSINESS TERM LOANS
Our business term loans are SBA loans. Please submit the signed applicaton, along with a full financial package (2 years tax returns, year to date p&l and balance sheet)
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UPLOADS
BROKER WRITE-UP (tell us about your file-be detailed)
*
Signed Application
*
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Equipment Quote/Invoice
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Bank Statement 1
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Bank Statement 2
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Bank Statement 3
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Bank Statement 4
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2024 Tax Return
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2023 Tax Return
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2022 Tax Return
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YTD P&L
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YTD BALANCE SHEET
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CDL/DRIVERS LICENSE
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VOIDED BUISNESS CHECK
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MISC (OTHER)
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