Business Funding Application Form

Business Funding Application Form

Complete this underwriting application and upload the required business and owner documents for review.
Business Information
Legal Business Name
DBA / Trade Name
Employer Identification Number (EIN)
Business Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Business Phone
Please enter a valid phone number.Format: (000) 000-0000.
Business Email
example@example.com
Website
Industry
Business Structure
State of Incorporation
Annual Revenue (Most Recent Tax Year)
Monthly Revenue
Average Daily Bank Balance
Number of Employees
Seasonal Business?
Owner / Principal Information
Full Name

First NameMiddle NameLast Name
Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Date of Birth

MonthDayYear
Date
Social Security Number (SSN)
Ownership Percentage
Title
Secondary Contact
Please enter a valid phone number.Format: (000) 000-0000.
Driver's License (Front and Back)

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Banking Information
Business Bank Name
Upload Last 6 Months of Business Bank Statements

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FOR FUNDING REQUESTS OVER $150,000 ONLY
Upload Most Recent Business Tax Return

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Upload YTD Financials (P&L & Balance Sheet)

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Funding Request Details
Amount Requested
Purpose of Funds
How Soon Funding Is Needed
Do You Currently Have Any Existing Advances or Loans?
Lender Name
Monthly Payment
Required Legal Disclosures
Information Accuracy Disclosure
Arbitration Agreement
Independent Brokerage Intermediary Notice

The applicant explicitly acknowledges that Reyes Commercial Capital LLC is a non-bank financial intermediary and independent capital advisory platform. Reyes Commercial Capital LLC does not issue direct balance sheet financing, consumer loan structures, or definitive underwriting approvals. Capital deployment, credit approvals, and final funding terms are determined exclusively at the sole discretion of third-party direct institutional lenders and syndicated funding partners.
Revenue-Based Financing Compliance Disclosure

Reyes Commercial Capital LLC facilitates capital procurement solutions across various structural asset classes. The applicant understands that Merchant Cash Advances (MCA) and Revenue-Based Financing products do not constitute commercial loan facilities or revolving extensions of credit. These specific transactions represent the purchase and sale of future business receipts at a contractually agreed-upon discount. Funded amounts, factor rates, and daily/weekly payment metrics do not represent an annualized percentage rate (APR) or interest metric.
Non-Circumvention, Exclusivity & Direct Sourcing Restriction

The applicant explicitly agrees that all capital sources, underwriting syndicates, alternative funding platforms, and private institutional lenders introduced to the applicant by Reyes Commercial Capital LLC represent proprietary financial networks. The applicant contractually covenants that it will not attempt to bypass, circumvent, or directly contact any lending entity or syndicate partner disclosed during this intake process. The applicant shall not submit direct capital applications or enter into financing agreements with said lenders independently for a period of twenty-four (24) months following the date of this submission without the explicit written participation and consent of Reyes Commercial Capital LLC. Violation of this provision entitles Reyes Commercial Capital LLC to seek full standard broker commissions and liquid damages from the applicant.
Background & Material Disclosures
* Does the applicant business, or any principal owner, have an open or active bankruptcy?
* Are there any active federal/state tax liens or legal judgments against the business exceeding $200,000?
Third-Party Verification & Tax Record Authorization

The applicant hereby grants Reyes Commercial Capital LLC and its syndicated underwriting partners the express authority to contact any business trade references, current or past alternative funding providers, landlords, or financial institutions to verify any information provided herein. The applicant further authorizes the procurement of official tax transcripts directly from the Internal Revenue Service (IRS) via Form 4506-T/4506-C if deemed necessary by underwriting syndicates for final validation.
Intermediary Status & Hold Harmless Provision
Authorization, Consent & Electronic Signature Agreement

By signing below, each of the above listed businesses and business owner/officer (individually and collectively, "you") authorize (Reyes Commercial Capital LLC) and each of its representatives, successors, assigns and designees ("Recipients") that may be involved with or acquire commercial business loans having daily/weekly repayment features or purchases of future receivables including Revenue-Based Financing transactions, including without limitation the application therefor (collectively, "Transactions") to obtain consumer and/or personal, business and investigative reports and other information about you, including credit card processor statements and bank statements, from one or more consumer reporting agencies, such as TransUnion, Experian and Equifax, and from other credit bureaus, banks, creditors and other third parties. You also authorize (Reyes Commercial Capital LLC) to transmit this Application, with any of the foregoing information submitted/obtained in connection with this application, to any or all of the Recipients for the foregoing purposes. You also consent to the release, by any creditor or financial institution, of any information relating to any of you, to ( ) and to each of the Recipients, on its own behalf. You intend to sign this Application electronically and consent to transacting business with (Reyes Commercial Capital LLC) and its affiliates electronically. You are providing your business cell phone and business email address and hereby consent to the receipt of correspondence/messages regarding transactions with (Reyes Commercial Capital LLC) and/or its affiliates on either medium. You also hereby consent to the receipt of text messages knowing that msg and data rates may apply (approximately 10 msgs/month). You understand that consent to conduct business via electronic signatures and to receive text messages are not a condition of approval and you may opt-out of either/both by contacting(Reyes Commercial Capital LLC) at funding@reyescommercialcapital.com . Your signature below certifies that you are authorized to sign this application on behalf of the Business and all the information contained herein is complete, true and accurate
Signature
Signature
Date

MonthDayYear
Date
Should be Empty:

Business Funding Application Form

Business Information

Owner / Principal Information

Banking Information

FOR FUNDING REQUESTS OVER $150,000 ONLY

Funding Request Details

Required Legal Disclosures

Signature