SMG Capital Access Form

SMG Capital Access Form

Complete the form below to be considered for Capital Access through SMG’s private network of lenders and investors.
Owner’s Information
Primary Contact Name

First NameLast Name
Primary Contact Email
example@example.com
Primary Contact Residential Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Contact Phone Number

Area CodePhone Number
Cell Phone Number

Area CodePhone Number
What kind of funding are you looking for?
How do you prefer to be reached?
What is your Credit Score Range?
Are there any other Co-Owners/Partners?
Co-Owner’s Information
Primary Contact Name

First NameLast Name
Primary Contact Email
example@example.com
Cell Phone Number

Area CodePhone Number
What is your Credit Score Range?
Business Entity Information
Business Legal Name
Business trade name or DBA
If applicable
What is the legal structure of your business?
Which state is your business in?
How long have you been in business?
Which industry is your business in?
Business EIN
What percentage (%) of the business do you own?
What is your title at the business?
CEO, Managing Partner, Director, etc.
Number of employees
How much funding are you requesting?
What is the Gross Annual Revenue for the business?
Briefly describe your business
Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Business Phone Number

Area CodePhone Number
Eligibility Questions
Have You Ever Defaulted on a Government Loan? (i.e. SBA Loan, Student Loan, etc.)
Are the majority owners of the business US citizens or Legal Permanent Residents?
Have you exhausted all funding options?
In a paragraph please explain why you need funding.
How will you using the funds: payroll, rent, inventory, etc.
Identification Verification

for Primary Contact
Upload Articles of Incorporation for your Business Entity

Browse Files

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Upload an image of your Government Issued I.D.

Browse Files
Driver's License, Passport Cancelof
Upload an image of your Social Security Card

Browse Files

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Upload an image of a Utility Bill

Browse Files
Your name must be listed as the account owner Cancelof
Consultant Information
Who is your Consultant at SMG or who is the person who referred you?
Thank you for applying for Capital Access through SMG. By submitting, you acknowledge that all information provided is true and complete. Should your profile align with our active lending and investment partners, you authorize a financial and credit review as part of due diligence. Certain third-party fees, such as appraisal costs, may be non-refundable if capital is not deployed. Once submitted, your application enters review with our Capital Division. For immediate assistance, contact TheSupremeSMG@gmail.com prior to submission.
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SMG Capital Access Form

Owner’s Information

Co-Owner’s Information

Business Entity Information

Eligibility Questions

Identification Verification

Consultant Information