Clearwater Business Capital
Business Name
*
E-mail
*
example@example.com
Phone Number
*
Business Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Industry Type
*
Federal Tax ID
*
Business start date under current ownership
*
-
Month
-
Day
Year
Date
State of Incorporation or Organization
*
What type of loan are you interested in?
*
Please Select
Business Term Loan
Equipment Loan
Merchant Cash Advance
Business Line of Credit
SBA Loan
Consolidation
How much capital do you need?
*
Please Select
15k-25k
25k-50k
50k-100k
100k-250k
250k-500k
500k-1m
1m+
How soon do you need funding?
*
Please Select
24-48 Hours
1-2 Weeks
3-4 Weeks
4 Weeks +
Do you have any open merchant cash advance or business loan accounts?
*
Yes
No
Lender Name & Balance
Lender Name & Balance
Lender Name & Balance
Merchant/Owner Information
Name
*
First Name
Last Name
Title
*
Ownership Percentage
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
SSN
*
Credit Score
*
Date of Birth
*
-
Month
-
Day
Year
Date
Second Owner's Information
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
SSN
Date of birth
-
Month
-
Day
Year
Date
Please Upload The Last 4 Months of Statements
Bank Statement 1 (PDF)
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Bank Statement 2 (PDF)
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Bank Statement 3 (PDF)
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Bank Statement 4 (PDF)
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*
By signing, each of the above listed businesses and business owner/officer (individually and collectively, "you") authorize (Clearwater Business Capital INC) and each of its representatives, successors, assigns and designees ("Recipients") that may be involved with or acquire commercial business loans having daily/weekly repayment features or purchases of future receivables including Revenue-Based Financing transactions, including without limitation the application therefor (collectively, "Transactions") to obtain consumer and/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 (Clearwater Business Capital INC) to transmit this Application, with any of the foregoing information submitted/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 (Clearwater Business Capital INC) and to each of the Recipients, on its own behalf. You intend to sign this Application electronically and consent to transacting business with (Clearwater Business Capital INC) and its affiliates electronically. You are providing your business cell phone and business e-mail address and hereby consent to the receipt of correspondence/messages regarding transactions with (Clearwater Business Capital INC) and/or its affiliates on either medium. You also hereby consent to the receipt of text messages knowing that msg and data rates may apply (approximately 10 msgs/month). You understand that consent to conduct business via electronic signatures and to receive text messages are not a condition of approval and you may opt-out of either/both by contacting (Clearwater Business Capital INC) at chris@cbcsls.com. Your signature above certifies that you are authorized to sign this application on behalf of the Business and all the information contained herein is complete, true and accurate.
Signature
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