Business Loan Application
Please fill out this information as accurately as possible to ensure a smooth process.
Legal Business Name(Merchant)
*
DBA Name(If applicable)
*
Business Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Business Website
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Business Start Date
*
-
Month
-
Day
Year
Date
Business Entity Classification (e.g., LLC, Corporation, Sole Proprietor)
*
Business Industry Type
*
Please Select
Medical/Dental Practice Acquisition
Medical/Dental Practice Expansion
Medical Equipment Financing
Healthcare Facility Renovation
Restaurant/Bar Acquisition
Restaurant/Bar Expansion
Franchise Acquisition
Hotel/Hospitality Property
HVAC Company Acquisition
HVAC Company Expansion
Construction Company Acquisition
Industrial Equipment Financing
Plumbing/Electrical Contractor
Self-Storage Facility Acquisition
Self-Storage Facility Expansion
Mobile Home Park Acquisition
Mobile Home Park Expansion
Owner-Occupied Business Building
Other
If other industry type, type here
Federal Tax ID / EIN Number
*
Ownership Percentage
*
Requested Loan Amount
*
Average Monthly Deposits
*
Applicant Full Name
*
First Name
Last Name
Personal Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Personal Email Address
*
Consecutive Bank Statements (4 months)
*
Browse Files
Drag and drop files here
Choose a file
Please upload all 4 months as a single PDF or individual files. *NOTE* Sometimes we may request up to 6 months for larger advances or borderline applications.
Cancel
of
Any Current Loans or Lenders?(i.e $95,000 DEFG BANK)
*
Loan Purpose(Brief Description)
*
How did you hear about us?
Additional Notes
If there's anything else you'd like us to know about.
Birthdate
*
-
Month
-
Day
Year
Date
SSN
*
Current Credit Score
*
Applicant's Signature
*
Continue
Continue
Should be Empty: