Shieldway Capital Funding Application

Shieldway Capital Funding Application
Owner Information
Name

First NameLast Name
E-mail of Applicant*
example@example.com
Phone Number*
Please enter a valid mobile number.
DOB:*
Alternate Phone Number
Please enter a valid mobile number.
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Owner Finalized
Ownership %*
SSN:*
Company Information
Legal Company Name:*
DBA:
Legal Entity*

LLCCorporationSole Proprietor
Business Start Date:
Tax ID:
Industry:*
Average Monthly Revenue:*
Last 3 months Bank Statements *

PDF Format - Valid Statements
Cancelof
AUTHORIZATIONS
By signing below, you authorize Shield Way Capital and its affiliates, agents, and assigns ("Recipients") to obtain personal and business credit, financial, and investigative information about you, including bank and credit card processing statements, from credit bureaus, financial institutions, and third parties. You also authorize the sharing of this application and related information with Recipients for evaluating business funding opportunities. You consent to any financial institution or creditor releasing relevant information to Shield Way Capital or its Recipients.
Signature*
Date:*
Should be Empty:

Owner Information