 |
Funding Application
|
Business Information
|
Legal Business Name:
|
Doing Business As:
|
Legal Entity Type:
|
Business Start Date:
|
Business Tax ID:
|
Incorporation State:
|
# of Employees:
|
Business Phone:
|
NAICS Code/Industry:
|
Business Email Address:
|
Website:
|
Business Description:
|
Approx. # of clients:
|
Business Location Details
|
Location Address:
|
Rented or Owned:
|
Monthly payment:
|
Landlord/Mortgage Contact Name:
|
Landlord/Mortgage Contact Phone#:
|
Owner/Partner/Member/Guarantor 1
|
Name:
|
Ownership %:
|
Date of Birth:
|
Home Address:
|
Social Security Number:
|
Phone:
|
Email Address:
|
Your Credit Score:
|
Do you own any property? (Y/N):
|
Co Owner/Partner/Member/Guarantor 2
|
Name:
|
Ownership %:
|
Date of Birth:
|
Home Address:
|
Social Security Number:
|
Phone:
|
Email Address:
|
Estimated Credit Score:
|
Do you own any property? (Y/N):
|
Financial Information
|
Gross Annual Sales:
|
Average Bank Balance:
|
Average CC Processing Volume:
|
Avg # deposits per month:
|
Desired Funding Amount:
|
Total Monthly Sales:
|
Have an outstanding Cash Advance or Business Loan?:
|
Lender/Funder Name:
|
Open Business Loan/Cash Advance Balance:
|
Use of Funding Proceeds:
|
Estimated Personal Annual Income:
|
Liquid Assets $ (401k, IRA, Investment Accts, etc.):
|
By signing below, each of the above listed business and business owner/officer (individually and collectively, “you”) certify that all information and documents submitted in connection with this application are true, correct and complete. You authorize Small Biz Heroes, LLC and each of its Marketplace Participants, and their respective representatives, successors, assigns and designees (“Recipients”) that may be involved with the facilitation of, or extending to you commercial business financing having daily, weekly or monthly repayment features or purchases of future receivables, including without limitation this application therefor (collectively, “Transactions”) to obtain consumer or personal, business and investigative reports and other information about you, including credit pulls, 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 are providing “written instructions” to Small Biz Heroes, LLC under the Fair Credit Reporting Act, authorizing Small Biz Heroes, LLC to obtain information from your personal credit profile or other information from the credit bureaus mentioned, solely to conduct a pre-qualification for credit. You also authorize Small Biz Heroes, LLC to transmit this application form, along with any of the foregoing information obtained in connection with this application, to any or all the Recipients for the foregoing purposes. You also consent to the release, by any creditor or financial institution, of any information relating to any of you, to Small Biz Heroes, LLC and to each of the Recipients, on its own behalf. You authorize Small Biz Heroes, LLC and its Recipients to contact you via e-mail, call and/or text-message at the e-mail address and/or phone number provided above, or at any e-mail address and/or phone number reasonably identified as belonging to you, including wireless numbers (if applicable), even if listed on a Do-Not-Call registry, using an automated telephone dialing system or other similar system with respect to this application, future-related commercial-financing opportunities and/or other lawful telemarketing purposes. You waive and release any claims against Small Biz Heroes, LLC, all Recipients, and any information-providers arising from any act or omission relating to the requesting, receiving, or release of information. By signing this application, I agree to receive documents electronically and acknowledge that my electronic signature is legally binding and equivalent to a handwritten signature.
Well done you did it! d