Purpose Fund - Business Funding Application

Business Funding Application

Apply for business funding by providing your business and ownership details. Please complete all required fields and upload your recent bank statements.
Business Information
Legal Business Name*
Entity Name
Business DBA
DBA
Business Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Business Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Business Email*
example@example.com
Federal Tax ID*
EIN
Date Business Started*

MonthDayYear
Date
Industry*
Select Your Industry
Merchant Details
Primary Owner Full Name*

First NameLast Name
Ownership Shares % (Primary Owner)*
Primary Owner Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Primary Owner Email*
example@example.com
Primary Owner Date of Birth*

MonthDayYear
Date
Primary Owner Social Security Number (Last 4 digits only)*
Merchant Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Merchant Details (Second Owner) - If Applicable
Second Owner Full Name

First NameLast Name
Ownership Shares % (Second Owner)
Second Owner Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Second Owner Email
example@example.com
Second Owner Date of Birth

MonthDayYear
Date
Second Owner Social Security Number (Last 4 digits only)
Upload 3–4 Months of Business Bank Statements*

For NY, UT, VA, CA - 4 months bank statements required
Cancelof
Date of Signing*

MonthDayYear
Date
Signature*
Should be Empty:

Business Funding Application