• Merchant Cash Advance Application Form

    Kindly fill out the application below to the best of your knowledge.

  • Business Information

  • Format: (000) 000-0000.
  • Date of Incorporation
     - -
    2 digit month, 2 digit day, 4 digit year

  • Business Owner's Information

  • Date of Birth*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Format: (000) 000-0000.

  • Second Business Shareholder's Information

  • Date of Birth
     - -
    2 digit month, 2 digit day, 4 digit year

  • Additional Shareholders

  • Third Business Shareholder Date of Birth
     - -
    2 digit month, 2 digit day, 4 digit year
  • Fourth Business Shareholder Date of Birth
     - -
    2 digit month, 2 digit day, 4 digit year

  • Funding Request

  • SIGNATURES – ALL OWNERS MUST SIGN – By signing below, the Client and its owner(s) certify that all information and documents submitted in connection with this Application are true, correct and complete. Additionally, the owner(s) authorize APX Funding or any of its agents, partners, and affiliates to contact the above landlord, supplier, and emergency contacts, as well as obtain and use business and non-business consumer credit reports from credit reporting agencies and any other information regarding the Client and its owner(s) from third parties, both at the time of the initial funding application and at any time after the Client has received funding as long as the Merchant remains a client of APX Funding. At all times, APX Funding will comply with the personal information collection, protection, use, sharing, and retention practices set out in the Privacy Policy *
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