FullyFundable Business Loan Application

Business Loan Application

GENERAL
Name of Person Completing Application

First NameLast Name
Were you referred by someone outside of FullyFundable or Dan Kalis?
Referral Source:
Desired Loan/Funding Amount
(Range: What's the least and most amount you can put to productive use in the near future?)
What is your urgency level for this funding inquiry?
Desired Use(s) of Funding (check all that apply)

Other
What (additional) types of marketing/advertising are you planning to do?
What positions are you looking to hire?
What type(s) of funding are you open to exploring? (check all that apply)
For Business Acquisition financing, please CLICK HERE to fill out our inquiry form specifically for that use of funds.
Business Legal Name
Business DBA Name (if different)
Company URL / Website Address (of primary business homepage)
Taxable Entity Type:

Other
Number of full-time employees/contractors
EIN (IRS Employee Identification Number)
(or state of residence if Sole Prop.)
State of Entity Registration
(or state of residence if Sole Prop.)
Business Start Date (Month/Year) (since incorporation)
Industry (NAICS code, if you know it)
Briefly describe what your business does, who it serves, and anything unique about your products/services, business model, expertise, etc.
Business Address

Street Address

Street Address Line 2 (or Suite/Unit/Floor)

CityState / Province

Postal / Zip Code
Business Phone Number

Area CodePhone Number
BUSINESS INFORMATION

FINANCIAL (estimates are sufficient for now)
Average Total MONTHLY Sales in past 6 months
2025 GROSS Revenue as reported on your business tax return
2025 NET Income (Profit/Loss) as reported on your business tax return
2024 GROSS Revenue
2024 NET Income (Profit/Loss)
Do you own back taxes to the IRS?
For which years do you owe back taxes to the IRS?
Are you on a payment plan with the IRS and in good standing?
Average Daily Cash Balance in Business Checking Account
How much are your total business expenses per month (average)?
How many months of business expenses do you have in cash reserves?
List any assets owned by your business (or personally) that could be pledged as collateral (type/class, estimated value, and available equity)
Business Bank Name
Merchant/Payment Processor(s)
BUSINESS INFORMATION

WORKSPACE
Company Basis (check all that apply)

Other
Commercial Rent / Mortgage Payment (per month, if applicable)
Landlord / Mortgage Company
(or own property free and clear)
Business Financial History
Types of Business Loans You've Had Previously (check all that apply)

Other
Have you ever defaulted on any of these business loans?
Please list type of loans on which you've defaulted
Has applicant/business ever filed for bankruptcy?
Does Applicant or Business have any judgments/suits pending?
If YES to either of two questions above, please explain: (nature/reason and dates)
Do you have any outstanding commercial loans/liens right now?
Loan/Lien #1
(type, lender name, balance due, monthly payment)
Loan/Lien #2
(type, lender name, balance due, monthly payment)
Loan/Lien #3
(type, lender name, balance due, monthly payment)
Have you gotten a Merchant Cash Advance (MCA) previously?
Do you have any open Merchant Cash Advances (MCAs) now?
(If yes) MCA Lender Name
(If yes) Current MCA Balance (total)
Business Loan Application

INDIVIDUAL GUARANTORS/APPLICANTS
How many partners of the company have at least 20% ownership
Primary Applicant/Guarantor
Name of Applicant #1

PrefixFirst NameMiddle NameLast Name
% Ownership
Title
Mobile Phone Number

Area CodePhone Number
Email Address of Applicant
Estimated Personal Credit Score (type actual score under "Other" if you know it)

Other
Home Address of Applicant

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Date of Birth of Applicant

MonthDayYear
Social Security # of Applicant #1
(We won't generate a hard credit inquiry without your prior knowledge)
#2 Applicant/Guarantor (20%+ owner)
Name of Applicant #2 (only if 20%+ owner)

PrefixFirst NameMiddle NameLast Name
Title of Applicant #2
Mobile Phone Number

Area CodePhone Number
Email Address of Applicant #2
example@example.com
Applicant #2 Estimated Personal Credit Score (type actual score under "Other" if you know it)

Other
% Ownership of Applicant #2
Home Address of Applicant #2

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth of Applicant #2

MonthDayYear
Social Security # of Applicant #2
(We won't generate a hard credit inquiry without your prior knowledge)
#3 Applicant/Guarantor (20%+ owner)
Name of Applicant #3 (only if 20%+ owner)

PrefixFirst NameMiddle NameLast Name
Title of Applicant #3
Mobile Phone Number of Applicant #3

Area CodePhone Number
Email Address of Applicant #3
example@example.com
Applicant #3 Estimated Personal Credit Score (type actual score under "Other" if you know it)

Other
% Ownership of Applicant #3
Home Address of Applicant #3

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth of Applicant #3

MonthDayYear
Social Security # of Applicant #3
(We won't generate a hard credit inquiry without your prior knowledge)
#4 Applicant/Guarantor (20%+ owner)
Name of Applicant #4 (only if 20%+ owner)

PrefixFirst NameMiddle NameLast Name
Title of Applicant #4
Mobile Phone Number of Applicant #4

Area CodePhone Number
Email Address of Applicant #4
example@example.com
Applicant #4 Estimated Personal Credit Score (type actual score under "Other" if you know it)

Other
% Ownership of Applicant #4
Home Address of Applicant #4

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth of Applicant #4

MonthDayYear
Social Security # of Applicant #4
(We won't generate a hard credit inquiry without your prior knowledge)
#5 Applicant/Guarantor (20%+ owner)
Name of Applicant #5 (only if 20%+ owner)

PrefixFirst NameMiddle NameLast Name
Title of Applicant #5
Mobile Phone Number of Applicant #5

Area CodePhone Number
Email Address of Applicant #5
example@example.com
Applicant #5 Estimated Personal Credit Score (type actual score under "Other" if you know it)

Other
% Ownership of Applicant #5
Home Address of Applicant #5

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth of Applicant #5

MonthDayYear
Social Security # of Applicant #5
(We won't generate a hard credit inquiry without your prior knowledge)
SUPPORTING DOCUMENTATION
Please share any other details about your business and proposed use of funds that you think would be helpful and informative for loan underwriting:
Please click the following link to our secure file portal and upload your recent 6 months of business bank statements (full, not summary) as well as a month-to-date (MTD) report/screenshots for this month so far for an initial funding review and pre-qualification.

(you can upload multiple files in each section)

** CLICK HERE TO UPLOAD BANK STATEMENTS **
Business Loan Application

APPLICATION AGREEMENT, AUTHORIZATION, SIGNATURE
The above information is warranted to be true and correct. I/we hereby authorize FullyFundable and/or its employees/contractors, assigns, agents, partner banks/lenders, or financial institutions, and underwriting personnel to verify and collect information on me/us, including but not limited to bank references, trade credit references, and/or personal and/or commercial credit reports. In compliance with the FAIR CREDIT REPORTING ACT, this is to inform you that you are authorizing this organization and/or its suppliers or partners to obtain a consumer and/or business profile credit report.
I agree that the information herein are true and correct
Typed/Printed Name
Relationship To Company/Owner(s)
I confirm that I am authorized to complete this application on behalf of the owner(s) of this company (or AS the/an owner), and all information provided above is accurate to the best of my knowledge
PLEASE USE "DRAW" (NOT (TYPE") FUNCTION TO HAND-SIGN WITH MOUSE/TRACKPAD
Signature
Date of Signature

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
DISCLAIMER: THIS DOCUMENT IS NOT TO BE CONSTRUED AS A TERM SHEET OR ANY OTHER KIND OF OFFERING DOCUMENT OR APPROVAL OF CREDIT. IT IS NOT AN OFFER TO SELL OR THE SOLICITATION OF AN OFFER TO PURCHASE AN SECURITY OR INVEST IN ANY PRIVATE PLACEMENT. ALL INFORMATION CONTAINED HEREIN HAS BEEN PROVIDED BY COMPANY MANAGEMENT. NONE OF THIS INFORMATION HAS BEEN INDEPENDENTLY INVESTIGATED OR VERIFIED. THERE IS NO REPRESENTATION OR WARRANTY AS TO ITS COMPLETENESS OR ACCURACY, IT IS SUBJECT TO CHANGE OR WITHDRAWAL WITHOUT NOTICE, AND MAY CONTAIN ERRORS. ALL PROSPECTIVE PARTIES TO A TRANSACTION SHOULD RELY UPON THEIR OWN VERIFICATION AND THE ADVICE OF THEIR REPRESENTATIVE (PROPERLY LICENSED) LEGAL, TAX, AND INVESTMENT PROFESSIONAL ADVISORS.
Should be Empty:

Business Loan Application

BUSINESS INFORMATION

BUSINESS INFORMATION

Business Financial History

Business Loan Application

Primary Applicant/Guarantor

#2 Applicant/Guarantor (20%+ owner)

#3 Applicant/Guarantor (20%+ owner)

#4 Applicant/Guarantor (20%+ owner)

#5 Applicant/Guarantor (20%+ owner)

SUPPORTING DOCUMENTATION

Business Loan Application