Flip Finance Application

Business Finance Application
Business Details
Business Name:*
Entity Name:
Business DBA:
DBA:
Business Address:*

Street Address

Street Address Line 2

CityState

Zip Code
Federal Tax ID (EIN):*
Business Start Date:*

MonthDayYear
Industry:*
Merchant Details
Merchant Name:*

First NameLast Name
Merchant Address:*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number:*
Email:*
john@example.com
Date of Birth:*

MonthDayYear
Social Security:*
Ownership Shares %:*
example: 100%
Credit Score:*
2nd Owner Name

First NameLast Name
2nd Owner Address:

Street Address

Street Address Line 2

CityState

Zip Code
2nd Owner Phone Number:
2nd Owner Email:
john@example.com
2nd Owner Date of Birth:

MonthDayYear
2nd Owner Social Security:
2nd Owner - Ownership Shares %:
example: 100%
2nd Owner Credit Score:
4 Months Bank Statements*

Cancelof
Signature

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By signing below, each of the above-listed business and business owner/officer (individually and collectively, “you”) authorize Flip Finance LLC and each of its representatives, successors, assigns 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 consumer or personal, business and investigative reports and other information about you, including credit card processor statements and bank statements, from one or more consumer reporting agencies, such as TransUnion, Experian and Equifax, and from other credit bureaus, banks, creditors and other third parties. You also authorize Flip Finance LLC to transmit this application form, along with any of the foregoing information obtained in connection with this application, to any or all of the Recipients for the foregoing purposes. You also consent to the release, by any creditor or financial institution, of any information relating to any of you, to Flip Finance LLC and to each of the Recipients, on its own behalf. You also authorize Flip Finance LLC and each of its Recipients to contact you via text message, automated call or email message at the contact information listed above.
Date

MonthDayYear
Date
Should be Empty:

Business Finance Application

Business Details

Merchant Details