Please complete all applicable fields. All information is help in strict confidence.

Business Legal Name

Doing Business As (DBA)

Borrower’s Credit Score

Business Web Address

What does this business do?

Business Phone

Business Address

City

State

Annual Business Revenue

Average Bank Balance

Monthly Credit Card Balance

Loan Amount Requested
USD $:

Requested Closing Time
PLEASE BE REASONABLE WHEN SELECTING CLOSING TIME. Timing significantly effects your financing options. For example: Selecting “< 60 Days" will automatically eliminate SBA financing as an option for this request which may be the best and least expensive financing option. Usually, the less time we have to close your loan, the more expensive the financing options will be.
Please select an option< 3 Days< 1 Week1 – 2 Weeks2 – 3 Weeks3 – 4 Weeks< 45 Days< 60 Days< 90 Days> 90 Days

Loan Purpose
Select all that apply
Purchase real estate for my businessPurchase a business in an industry I am experienced inPurchase a business in an industry I am NOT experienced inStartup a business in an industry I am experienced inStartup a business in an industry I am NOT experienced inRefinance my business property mortgage for a lower rateRefinance my business property mortgage and pull out cashConstruct a building for my businessWorking capital (cash for any business use)Renovations or leasehold improvementsConsolidate expensive merchant cash advancesAccount receivable financingBuy equipmentBuy inventoryHire staffMarketing / Advertising

Contract Expiration Date if Purchasing Real Estate / Business

Real Estate or Business Purchase Price
If applicable.

Is business “business-to-business” (B2B) or “business-to-consumer” (B2C)?
Please select an optionB2BB2CBoth B2B and B2C (mostly B2B)Both B2B and B2C (mostly B2C)Equally B2B and B2C

Business Entity Type
Please select an optionLLCLLPCorporationSole ProprietorshipTrustNon-Profit

Business Start Date

Borrower’s Full Name

Borrowers Email

Borrowers Phone #

Who is submitting this application?
Please select an optionThe BorrowerA third-party working with the Borrower to obtain financing

Best Email for Processing Updates

Submitter’s Full Name
Complete only if Submitter is NOT the Borrower

Submitter’s Email
Complete only if Submitter is NOT the Borrower

Submitter’s Phone #
Complete only if Submitter is NOT the Borrower

How did you hear about us?

Borrower’s % Business Ownership

Does Borrower Rent or Own Primary Residence
Please select an optionRentOwn

Landlord Name

Landlord Phone

Is the borrower a US citizen or permanent residential alien?
Please select an optionYesNo

Has the borrower defaulted on an SBA, student or government loan?
Please select an optionYesNo

Last Borrower Bankruptcy
Please select an optionNeverPresently in Bankruptcy> 1 Year> 2 Year> 3 Year> 4 Year> 5 Year> 6 Year> 7 Year

Last Borrower Foreclosure
Please select an optionNeverPresently in Foreclosure> 1 Year> 2 Year> 3 Year> 4 Year> 5 Year> 6 Year> 7 Year

Amount of Past Due Income Taxes

Amount of Past Due Real Estate Taxes

Amount of Unsatisfied Judgements

How can we verify the business’s income?
Select all that apply
Tax returns (up-to-date)Tax returns (current year is on extension)Business bank statementsFinancial statements (profit & loss / balance sheet)No income documentation is availableProjections only, this is a startup business

Does the merchant have a separate business bank account?
YesNo

Has the merchant accepted credit cards for 3 months or more?
YesNo

Does the merchant have a merchant cash advance (MCA)?
YesNo

Business Location Address

Business Location Rented or Owned
Please select an optionRented – Commercial LocationOwned – Commercial LocationRented – Home Based BusinessOwned – Home Based Business

Monthly Business Location Rent or Mortgage Payment

Business Location Type
Please select an optionThis is the borrower's primary residenceThis is a single family investment property the business occupiesThis is a 2 family property the business occupiesThis is a 3 family property the business occupiesThis is a 4 family property the business occupiesThis is a 5+ family property the business occupiesThis is land currently used for the businessOffice buildingOffice condominiumRetail buildingRetail condominiumRetail strip mallWarehouseIndustrial buildingManufacturing facilityMixed-use property < 50% commercial spaceMixed-use property > 50% commercial spaceSelf storage facilityMobile home parkRV parkFlagged hotelFlagged motelUnflagged hotelUnflagged motelAutomotive repair / serviceGas stationOther (please specify in the Notes section at the bottom)

What percent of the ‘Business Location” above does the business occupy?

Business Location Mortgage Balance
Complete if the property is owned, if rented type “0”.

Business Location Estimated Value
If you are in contract to purchase this property, please list the actual purchase price NOT your estimate of value. If this property is rented, type “0”.

Additional Real Estate Collateral Address
Please include any additional real estate collateral the borrower owns that may be available to collateralize for this loan request. Leave blank if none.

Additional Real Estate Collateral Type
Please select an optionNoneBorrower's primary residenceBorrower's second / vacation homeInvestment single family residenceInvestment 2 family propertyInvestment 3 family propertyInvestment 4 family propertyInvestment 5+ family propertyVacant landOffice buildingOffice condominiumRetail buildingRetail condominiumRetail strip mallWarehouseIndustrial buildingManufacturing facilityMixed-use property < 50% commercial spaceMixed-use property > 50% commercial spaceSelf storage facilityMobile home parkRV parkFlagged hotelFlagged motelUnflagged hotelUnflagged motelAutomotive repair / serviceGas stationOther (please specify in the "Notes" section at the bottom)

Additional Real Estate Collateral Mortgage Balance
Complete if the property is owned, if rented or there is no “additional real estate collateral” type “0”.

Additional Real Estate Collateral Estimated Value

Total Balance of Merchant Cash Advances (MCAs)

Total Balance of SBA Loans

Total Balance of OTHER Business Debt
Do not include Business Real Estate Mortgages, Merchant Cash Advances (MCAs) or SBA debt listed above. This field is for ADDITIONAL business debt.

Total 2016 Gross Business Income
This is total business income before subtracting expenses.

Total 2016 Net Business Income
This is total business income – expenses and + depreciation, amortization and interest expense of any debt to be paid off with this financing.

Does the business have any commercial accounts receivable?
“Commercial” accounts receivable are business-to-business receivables or invoices for which a service has been performed for another business and is still pending payment. Business-to-consumer accounts receivable do not qualify.
—Please choose an option—YesNo

Total Borrower Liquid Assets
List the total figure of “verifiable” liquid assets in the borrower’s possession. Include business and personal: Checking, savings, CDs, retirement and publicly traded stock/mutual fund accounts.

Notes
Please note any information you feel is necessary for us to know

Please select those documents you currently have in your possession
After review of your application, processing will reach out to request additional documentation from you.
To save time, please have those documents prepared in advance (if possible). Some of the below items are documents processing may require, not all are required or may apply.

NoneSigned Term financing credit applicationBorrower credit reportSigned personal financial statementLast 3 months business bank statementsLast 6 months business bank statementsLast 2 years personal tax returnsLast 2 years business tax returnsLast 2 years business P & L statementsLast 2 years business balance sheetsYTD business P & L statementYTD business balance sheetBusiness debt scheduleSigned letter/s of explanation for any issuesCopy of tax lien/s payment plan