Blue Mountain Capital
Application
Business Information
Business Name
*
Business EIN
*
Business Start Date
*
/
Month
/
Day
Year
Date
Annual Revenue
*
Entity Type
*
Please Select
LLC
Sole Proprietorship
C Corp
S Corp
Partnership
Non-Profit
Co-op
Industry Type
*
Website
Do you accept credit cards?
*
Please Select
Yes
No
How much money are you looking to finance?
*
Have you taken out any loans in the past 12 months?
*
Please Select
Yes
No
If yes, are they paid off?
Please Select
Yes
No
I'm in default
Don't worry we can still help you if you're not paid up and or have defaulted in the past.
Loan balance
What is the current balance on the loan(s) you have out. If you don't have any loans out, please leave blank.
Business Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
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Blue Mountain Capital
Loan Application
Owner Information
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Home Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
DOB
*
/
Month
/
Day
Year
Date
SSN
*
Ownership
*
Please Select
100%
50%
25%
POA
Credit Score
*
Please Select
700+
620-699
500-619
Below 500
Unsure
If you are unsure, don't worry we will confirm with a soft credit pull.
Do you own real estate?
Please Select
Yes
No
Estimated real estate value?
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Partner Information
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
DOB
/
Month
/
Day
Year
Date
SSN
Ownership
Please Select
100%
50%
25%
POA
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Bank Statements
File Upload
Browse Files
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By signing below, each of the above listed business and business owner/officer (individually and collectively, “you”) certify that you are authorized to sign on behalf of the named business, all information and supporting documentation submitted with this application are true, correct and complete and all such information may be relied upon by Blue Mountain Capital Funding Group (“BMCFG”) and the Recipients (defined below). You hereby authorize Blue Mountain Capital Funding Group (“BMCFG) and each of its representatives, successors, assigns, designees and third-party funding partners which includes lenders and other finance brokers with whom BMCFG has, or may in the future enter into, commercial brokerage-financing relationships (“Recipients”) that may be involved with or acquire commercial loans having daily repayment features or purchases of future receivables including Merchant Cash Advance transactions:(1) to obtain consumer or personal, business and investigative reports and other information about you, including hard and/or soft credit pulls, from one or more consumer reporting agencies, such as TransUnion, Experian and Equifax;(2) to obtain credit card processor statements and bank statements from banks, creditors and other third parties; (3) to obtain the release, by any creditor or financial institution, of any information relating to you, to any Recipients; and (4) to transmit this application form, along with any of the foregoing information obtained in connection with this application, to any or all Recipients for the foregoing purposes. You further certify that should any of the foregoing information change, to the extent within your knowledge, that you will promptly notify BMCFG of such changes. A copy of this authorization may be accepted as an original whether sent via email or facsimile.
*
Yes
Owner 1 Signature
*
Date
*
/
Month
/
Day
Year
Owner 2 Signature
Date
/
Month
/
Day
Year
Submit
Submit
Should be Empty: