Sunset Debt Relief Application

Business Legal Name*

Business DBA if applicable

Business Phone*

Website

Email*

example@example.com

Business Address*

Physical Address

Street Address Line 2

CityState

Zip

Legal Entity*

Open Judgement? Liens?*

YesNo

Open Bankruptcies?*

YesNo

Business Start Date*

Date

Federal Tax ID*

Industry Type (SIC Code)*

State of Incorporation*

Gross Annual Sales*

Business Description*

Business Monthly (Rent, Lease, Mortgage) Payment Amount*

Gross Monthly Sales*

Monthly Credit Card Volume*

Current Loan Balance?*

Who are your current loans with, and what are each of their remaining balances?*

Ex: "Loan Provider 1: $50,000, Loan Provider 2: $20,000, Loan Provider 3: $11,500" etc...

First Name*

Last Name*

Title*

Percent Ownership*

Home Address*

Home Address

Street Address Line 2

CityState

Zip

Cell Phone*

Date of Birth*

Date

Social Security Number*

First Name

MI

Last Name

Title

Ownership

Address

Home Address

Street Address Line 2

CityState

Zip

Cell Phone

Date of Birth

Date

Social Security Number

By signing below, each of the above-listed business and business owner/officer (individually and collectively, "you") authorize Sunset Debt Relief LLC and each of its representatives, partners, assignees, and designees ("Recipients") to obtain, consumer 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 Sunset Debt Relief LLC to transmit this application and any of the foregoing information obtained in connection with this application to all the Recipients in our secure network for the purposes of procuring financial options for your business. You also consent to the release, by any creditor or financial institution, of any information relating to you, to Sunset Debt Relief LLC and to each of the Recipients, on its own behalf. Under no cimcumstances will your information be sold, or shared with anyone outside of our network for any other purpose than to underwrite offers for your business.

Owner Signature*

Printed Name*

Date*

Date

Co-Owner Signature

Co-Owner Printed Name

Co-Owner Date

Date

Please upload your last 4 months of business bank statements as well as all of your current loan contracts.*

Notes

Sunset Debt Application

Contact Information

Business Information

Owner / Principal Information

Co-Owner Information

Authorization