Business Funding Request Form- Application For Funding

Business Funding Request
With direct access to over 10 lenders we can help any personal credit, industry or need within 48 hours. Final funding offers and terms will be in writing from approved funder within 5 business days.
Name Of Your Business*
Reason For Business Funding*

Starting a new businessBuying an existing businessExpanding your current businessBuying out your partnerLeasing equipment to growRefinance current equipmentSecure a business loan up to $100,000Other
Business Type*

Private Limited CompanyPublic Listed CompanyCooperativeSole ProprietorshipPartnershipOther
Funding amount you require*

Less than $20,000$20,000-60,000$60,000-100,000More than $100,000
Approximate day my business registered*

MonthDayYear
Date
Business Address registered on your corp documents or as seen on Google listing.*

Street Address

Street Address Line 2

CityState / Province

Postal
Company Email*
example@businessemail.com
Applicants Name*

First NameLast Name
Date of Birth of applicant*

MonthDayYear
Date
Applicant Phone Number *
Please enter a valid phone number.Format: (000) 000-0000.
Applicant SIN Number *
Please completeFormat: 000-000-000.
Your net worth (Assets minus liabilities)*

Less than $ 250,000$ 251,000-$500,000Over $500,000
Your Approximate Credit Score*
Declared Revenue from 2025*
Have you ever declared bankruptcy or consumer proposal?*
Are you up to date with your personal and business taxes?*
Please upload related documents ( Drivers License of applicant )

Cancelof
My business has a company business bank account*

Yes I have a business accountNo as I use a personal accountI need help setting up a business account
In the ideal situation how can we help your business this week?
How soon do you need the financing approval?*

Less than 5 days1-2 weeks1 monthOver a monthJust curious about what I can do
Are you currently working with another lender or brokerage in the last 3 months?*

YesNoI have a approval with a lender today in handNo, but ill be shopping between multiple lenders for funding
Today's Date*

MonthDayYear
Date
Lenders will need to review up to 12 months of bank statements to verify revenue. I will email over bank statements in PDF today when required.*

YesNo
Signature- By signing this form we are allowing LeasePoint Canada group the ability to review personal credit through Equifax, FICO and Transunion. Upon approval notice I am committed to moving forward with business funding within the next 2 business days. All leases are approved based on time in business, industry, banking history and personal credit. Admin fees may be charged on files that are deemed fraudulent by lenders and your committed to submitting documents that are true to your application. *
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Business Funding Request

With direct access to over 10 lenders we can help any personal credit, industry or need within 48 hours. Final funding offers and terms will be in writing from approved funder within 5 business days.