Mondra Capital – Business Loan Application

Product / Loan Type*

Full Name*

First NameLast Name

Email Address*

Phone Number*

Area CodePhone Number

Date of Birth

Social Security Number (SSN)*

EIN (Employer Identification Number)*

Business Name*

Business Industry / Type*

Business Start Date

Average Monthly Revenue*

Funding Amount Requested*

Purpose of Funds*

Upload Bank Statements (Last 3–6 Months)*

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Additional Documents

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Disclaimer & Authorization

By submitting this application, I hereby certify that all information provided is true, accurate, and complete to the best of my knowledge. I authorize Mondra Capital LLC and its affiliate lenders, partners, and assignees to obtain consumer and/or business credit reports, verify employment and income information, and conduct any investigation necessary to process this application. I understand that submitting this application does not guarantee approval or commitment to fund.

I consent to be contacted by Mondra Capital LLC and its partner lenders via telephone, email, text message (SMS), or other electronic means regarding this application and related financing products, even if my number is listed on a Do Not Call registry. Message and data rates may apply.

I acknowledge that a Merchant Cash Advance (MCA) is a purchase of future receivables and not a loan. Factor rates, payment frequency, and total payback amounts will be disclosed prior to execution of any agreement. I have the right to review all terms before signing.

I authorize Mondra Capital LLC to share my application information with its network of funding partners solely for the purpose of obtaining business financing. My information will not be sold or used for any other purpose. For questions, contact info@mondracapital.com.