J&M Funding Application

FUNDING APPLICATION
BUSINESS INFORMATION
Business LEGAL Name
Business DBA Name
Business Street Address

Business Street Address

Street Address Line 2

City, State, Zip CodeState / Province

Postal / Zip Code
Business Mailing/Billing Address

Business Mailing/Billing Address

Street Address Line 2

City, State, Zip CodeState / Province

Postal / Zip Code
Main Contact
Phone Number
Format: (000) 000-0000.
Email Address
Website
Federal Tax ID#
Years in Business
Years with Current Ownership
Type of Ownership

Other
If Corporation, what is the state of incorporation?
Type of Business

Other
Type of Goods Sold and/or Services Offered
OWNERSHIP INFORMATION

Owner 1
Name
Title
Ownership Percentage
Street Address
City, State, Zip Code
Phone Number
Format: (000) 000-0000.
Social Security Number
Date of Birth

MonthDayYear
Date
OWNERSHIP INFORMATION

Owner 2
Name
Title
Ownership Percentage
Street Address
City, State, Zip Code
Phone Number
Format: (000) 000-0000.
Social Security Number
Date of Birth

MonthDayYear
Date
FINANCIAL INFORMATION
Average Monthly Total Sales
Average Monthly Credit Card Sales
Desired Advance/Funding Amount
Do you have an OPEN cash advance or dining program?
If Yes,
Company, and Phone #
Have you used a cash advance program before?
If Yes,
Company, and Phone #
Are any suits/judgments/liens pending against the business?
If Yes, provide details
Has the business or any of its owners ever declared bankruptcy?
If Yes:
Discharge Date
State
Chapter
Are any suits/judgments/liens pending against the business?
If Yes, provide details
By signing below, the undersigned certifies that all information provided in this Funding Application is true, correct, and complete. The undersigned authorizes J&M Group, its representatives, and designated funding partners to obtain consumer and business credit reports, bank/processor statements, and other financial information as needed to evaluate this application and provide financing options.

The undersigned further consents to the release of such information by any creditor or financial institution to J&M Group and its funding partners. Applicant also agrees to receive communications (calls, emails, and text messages) regarding this application. Message and data rates may apply.
SIGNATURE
Title
Print Name
Date

MonthDayYear
Date
Upload Required Documents

Please upload the following documents for review: Last 3–6 months of business bank statements (PDF format preferred), Most recent business tax return (if available), Voided business check (for funding deposits), Owner’s government-issued ID (driver’s license or passport) Note: All files are kept confidential and used solely for underwriting and funding evaluation.
Cancelof
Should be Empty:

FUNDING APPLICATION

OWNERSHIP INFORMATION

OWNERSHIP INFORMATION

FINANCIAL INFORMATION