Avenew Funding Application

Company Name*
Name*

First NameLast Name
Email*
example@example.com
Business Phone Number*
Please enter a valid phone number.
Mobile Phone Number*
Please enter a valid phone number.
Business Address*

Street Address

Street Address Line 2

CityState

Zip Code

Business Start Date*

MonthDayYear
Date
Federal Tax ID (EIN)*
Legal Entity Type
Average Monthly Revenue/Deposits*
Average Dollar Amount Deposited Per Month Into Business Bank Account
Requested Funding Amount*

Owner 1 Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Owner 1 Ownership %*
Owner 1 Social Security Number*
Owner 1 Date of Birth*

MonthDayYear
Date
Is there a second owner of the business who owns more than 49%?*

NoYes

Signature

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You acknowledge that this application is intended solely for informational and application purposes and does not establish any agreement to provide funding to you or your Company (as identified above). By signing below, you affirm and confirm the following: (i) you have the authority to apply for funding on behalf of the Company, and (ii) all information submitted here, along with any supporting documents, is truthful, accurate, and complete, and such information may be relied upon by Avenew Funding (“Avenew”) and the Recipients (as defined below). You grant permission to Avenew and its representatives, successors, assigns, designees, and third-party funding partners—including lenders and other financial providers with whom Avenew currently has or may establish commercial-brokerage-financing relationships (“Recipients”)—to: (1) obtain consumer, personal, business, and investigative reports and other information about you, including hard and/or soft credit inquiries, from one or more consumer reporting agencies such as TransUnion, Experian, and Equifax; (2) acquire credit card processor statements and bank statements from banks, creditors, and other third parties; (3) receive the release of any information relating to you from any creditor or financial institution to any Recipients; (4) share this application form along with any obtained information with any or all Recipients for the purposes stated above; and (5) contact you via email, phone call, and/or text message at the email address and/or phone number provided above, or any reasonably identified email address and/or phone number associated with you, including wireless numbers (if applicable), even if listed on a Do-Not-Call registry, using an automated telephone dialing system or similar technology regarding this application, future related commercial financing opportunities, and other lawful telemarketing purposes. You also certify that if any of the information provided changes, to the best of your knowledge, you will promptly inform Avenew of such updates. A copy of this authorization may be accepted as an original whether transmitted via email or fax. By signing, you agree to notify Avenew Funding immediately of any changes to this information.
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