BUSINESS FUNDING APPLICATION
Please complete this application accurately. This information is required to match you with qualified funding partners. Submitting this application does not obligate you to accept funding.
SECTION 1: BUSINESS INFORMATION
Legal Business Name:
DBA (if applicable):
Business Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Business Phone Number:
Business Email Address:
example@example.com
SECTION 2: BUSINESS PROFILE
Business Structure (LLC / Corporation / Sole Proprietor / Partnership):
Federal Tax ID (EIN):
Industry Type:
Time in Business (years/months):
SECTION 3: FUNDING REQUEST
Requested Funding Amount ($):
Primary Use of Funds (check one): Working Capital / Equipment / Expansion / Real Estate / Payroll / Other
Working Capital
Equipment
Expansion
Real Estate
Payroll
Other
Brief Description of Use of Funds:
SECTION 4: FINANCIAL INFORMATION
Average Monthly Gross Revenue ($):
Most Recent 3 Months Revenue Consistent? Yes / No
Yes
No
Estimated Business or Personal Credit Score Range: 720+ / 680-719 / 620-679 / Below 620 / Not Sure
720+
680-719
620-679
Below 620
Not Sure
SECTION 5: BUSINESS OWNER / GUARANTOR INFORMATION
Owner Full Legal Name:
Ownership Percentage (%):
Owner Phone Number:
Owner Email Address:
example@example.com
SSN (Last 4 digits only):
SECTION 6: AUTHORIZATION & CERTIFICATION
I certify that all information provided in this application is true and accurate. I authorize Caribbean Business Solutions and its funding partners to verify the information provided and to contact me regarding available funding options. I understand that this application does not guarantee approval or obligate me to accept funding.
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Applicant Signature:
Date:
-
Month
-
Day
Year
Date
Submit
Should be Empty: