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Business Information

Business Legal Name

Doing Business As (DBA)

Type of Legal Entity

Corporation

Sole Proprietorship

LLC

Partnership

Address

Suite/Floor

City

State

Zip

Phone

Mobile

Website

Funding Information

Nature of Business

Type of Product/Service Sold

Average Monthly Credit Card Volume

Average Monthly Sales

Annual Business Revenue

Number of Business Bank Accounts

Average Daily Bank Balance

Desired Funding Amount

Purpose of Funds Requested

Is Funding for Commercial Real Estate?

Yes

Projected Transaction

Owner(s)/Principal Information

Owner 1 Name

Owner 1 Address

Owner 1 City

Owner 1 State

Owner 1 Zip

Owner 1 Email

Owner 1 Percentage of Ownership

Is There Another Owner?

Yes

Owner 2 Name

Owner 2 Address

Owner 2 City

Owner 2 State

Owner 2 Zip

Owner 2 Email

Owner 2 Percentage of Ownership

By submitting this application, the Merchant and its owners/principals:

Certify that all information and documents submitted in connection with this Application are true, correct and complete; and
Authorize Capital Business Solutions, LLC, its agents, partners and lenders, to receive credit reports, and any other information regarding the Merchant and its owners/principals from third parties, to verify any information provided on the Application

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Business Information

Funding Information

Property Information

Projected Transaction

Owner(s)/Principal Information

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