FlashCap Advance MCA

Business Owner Information
Name*

First NameLast Name
Address*

Home Address

Street Address Line 2

CityState

Zip
Phone #*
Email*
example@example.com
DOB*

MonthDayYear
Date
Ownership %*
SSN*
Credit Score*
Business Information
Legal Name*
DBA*
Tax ID / EIN*
Type of Entity*
Business Email
example@example.com
Business Phone
Business Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date Business Started*

MonthDayYear
Date
Industry
Avg Monthly Revenue $*
Amount Requested $*
Do you accept debit/credit card payments?*

YesNo
I authorize FlashCap Advance and its funding partners to contact me by phone, text, or email at the number/email I provided (including autodialed and prerecorded calls/texts I understand I can revoke this consent at any time.

I authorize FlashCap Advance and its funding partners to obtain consumer and business credit reports on me and my business.

I confirm the information provided is true and accurate to the best of my knowledge. I understand misrepresentation may void any funding offer.

I acknowledge this is a purchase of future receivables and NOT a loan. There is no fixed payment schedule, no interest rate, and no personal guarantee on most offers.

I agree to electronic signatures and delivery of all documents. This is legally binding under the ESIGN Act.

*By signing and submitting this document, you agree to the above terms*
Attach previous three months of business bank statements:

Cancelof
Applicant Signature*

Clear
Should be Empty:

Business Owner Information

Business Information