Merchant Application
With what company is your cash advance?
How much did you get funded?
What is your balance?
What was the payback/cost?
Daily
Weekly
(If figure is a percentage it's a merchant acct. If figure is a monetary value its an ACH)
How much CASH?
How soon do you need it?
Use of CASH needed?
Monthly Bank Deposits? (Estimate)
Monthly credit card sales?
Gross anual business sales?
Second business?
Yes
No
If YES, Peak Sales Months? From:
Ex. (May to September)
What do you think your credit score is? (Estimate)
Owner(s):
Partner:
Cell Phone Number
Format: (000) 000-0000.
Email
example@example.com
Do you have any TAX LIENS, JUDGEMENTS, PENDING CLAIMS against you or your business?
Yes
No
Is it for sales tax, corporation tax, or personal tax? Explain:
Business name
Type of Business
Years in business
Business Address
Business Phone
Format: (000) 000-0000.
Fax Number
Submit
Should be Empty: