Geneius Capital – Business Funding Application
Complete the short form below to get pre-approved. This will not affect your credit score.
Legal Business Name
*
DBA (if applicable)
Entity Type
*
Please Select
Sole Proprietor
LLC
Corporation
Partnership
Industry
*
Time in Business
*
Please Select
Less than 6 Months
6-12 Months
1-2 Years
2+ Years
State of Incorporation or Organization
*
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Federal Tax ID / EIN
*
Business Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Business Phone Number
*
Please enter a valid business number.
Email Address
*
example@example.com
Average Monthly Revenue
*
Funding Amount Requested
*
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Owner Information
Owner Full Name
*
First Name
Last Name
Title / Role
*
Ownership Percentage %
*
Date of Birth
*
-
Month
-
Day
Year
Date
Credit Score
*
Social Security Number (Last 4 Digits)
*
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Owner Signature
*
By signing above, the above-signed (“Applicant”) authorizes Geneius Capital and its funding partners, lenders, and service providers (collectively “Company”) to obtain, verify, and review any information deemed necessary to evaluate this application, including but not limited to: business and personal credit history, banking information, and other financial data. Applicant certifies that all information provided in this application and any accompanying documents is true, complete, and accurate. Applicant understands that this is an application for a commercial business funding program, not a consumer loan, and that Geneius Capital is not a lender but works with multiple lending partners to arrange financing options. Applicant authorizes the Company and its partners to contact them via phone, SMS, or email, including the use of automated technology, for purposes related to this application or future offers, even if the number provided is listed on a federal or state Do Not Call registry. This authorization shall remain in effect for a reasonable period of time to allow for the evaluation and ongoing servicing of any funding obtained.
Date of Submission
*
-
Month
-
Day
Year
Date
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Upload Documents
Last 4 Months of Business Bank Statements
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Additional Documents
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