Business Funding Application
Business Name
*
Business DBA Name
*
Business Address
*
Business Street Address
Street Address Line 2
Business City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Business State
Business Zip Code
Federal Tax ID
*
Business Entity Type
*
Please Select
LLC
Sole Proprietorship
Corporation
Partnership
Nonprofit
Other
Business Start Date
*
/
Month
/
Day
Year
Industry
Industry
*
Please Select
Accounting / CPA
Adult Entertainment / Novelty Store
Auto Detail Services
Auto Mechanic
Auto Sales
Autobody Repair And Service
Bail Bonds
Boat Sales
Cannabis
Carwash
Casino
Church / Places Of Worship
Concert / Event Planning
Construction
Credit Repair Services
Daycare / Schools Or Academys
Electrical Services
Equipment / Auto / Tool Rental Services
Farming
Finance Company
Firearms / Ammunition
Forestry / Logging
Funeral Home / Services
Gas Station
General Contractor
Grocery / Hardware Store
Gym / Fitness Services
Hotels
HVAC Services
Insurance Agency / Services
Janitorial / Cleaning Services
Jewerly Retail Or Wholesale
Landscaping / Lawncare / Grading Services
Lawyers
Manufacturing / Industrial Plants / Recycling
Marketing / Consulting / IT / Communication / Data Services
Medical / Veterinarian / Specialty Services
Moving / Furniture Delivery Services
Nail Salons / Hair Salons / Tanning Salons / Beauty Supply / Spa
Non-Profit
Nursing / Senior Care / Rehab Facility / Hospice
Pawn Shop
Payday Loans / Check Cashing / Debt Collection Agencies
Payroll Services
Pharmacy / Drug Store
Plumbing
Real Estate / Real Estate Agency
Restaurant / Bar / Catering Services
Retail Goods / Online Ecommerce
Roofing
RV Sales
Security Firms / Services
Shipping / Distribution Services
Solar
Staffing And Recruiting Agencies
Tabacco / Vape Shop
Tax Services
Towing Service
Trucking / Transportation
Wholesale / Distribution
Other
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Owner/ Principal Information
Owner Name
*
First Name
Last Name
Owner Address
*
Owner Street Address
Street Address Line 2
Owner City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Owner State
Owner Zip Code
E-mail
*
Cell Phone
*
Format: (000) 000-0000.
Date of Birth
*
-
Month
-
Day
Year
Date
SSN #
*
% of Ownership
*
Please Select
1%
2%
3%
4%
5%
6%
7%
8%
9%
10%
11%
12%
13%
14%
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85%
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88%
89%
90%
90%
91%
92%
93%
94%
95%
96%
97%
98%
99%
100%
% of Ownership
*
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Financial Information
Have you ever had an MCA before?
*
Yes
No
If yes, have you ever defaulted
Please Select
No defaults
Defaulted and resolved (settled or paid off)
Defaulted and currently unresolved
If yes, please list lender name(s)
Do you currently have an MCA?
*
Yes
No
If yes, please list current MCA Lenders & Balances
*
Monthly Revenue
*
Credit Score
*
Please Select
800+
750–799
700–749
699-650
500-549
Below 500
Do you own any real estate?
*
Yes
No
How much do you owe on your mortgage?
How much you think your properties worth?
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Secure Bank Statement Upload
We're excited to help your business grow. To proceed with your funding application, please upload your last 4 business bank statements below.
Required Documents:
Most recent 4 months of complete business bank statements
All pages must be included for each month
Month 1
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Month 2
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Month 3
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Month 4
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Consent & Signature
By submitting this form, I authorize Fast Funds Group LLC and its third-party partners to obtain and review my business and personal credit information, bank statements, and underwriting data for financing evaluation. I authorize the release of information from financial institutions and service providers as needed to process my request, and I consent to be contacted by phone, SMS, and email regarding my application and financing options.
*
Yes, I agree
Signature
*
Date Signed
*
/
Month
/
Day
Year
Date
broker_id
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