CASH ADVANCE FUNDING LLC APPLICATION BUSINESS INFORMATION 1Legal/Corporate Name *DBA – doing business as *Physical Business Address *City, State, Zip *Main Business Phone Number *Fax Number *Email *EIN Number *Length in business/ start date: *Website: *Entity type: LLC, General Partnership, C Corporation, Limited Liability Partnership LP, etc.: *State of Entity *Number of locationsBUSINESS INFORMATION 2 (IF APPLICABLE)Legal/Corporate NameDBA – doing business asPhysical Business Address:City, State, ZipMain Business Phone NumberFax NumberEmailEIN NumberLength in business/ start dateWebsiteEntity type: LLC, General Partnership, C Corporation, Limited Liability Partnership LP, etc.:State of EntityNumber of locationsOwner/Corporate Office Name and Title *Personal Credit Score *% Ownership *Home AddressCity, State, ZipSSN#Date of BirthCell Phone #Business Phone #PARTNER INFORMATION #1Partner Name and TitlePersonal Credit Score% OwnershipHome AddressCity, State, ZipSSN#Date of BirthCell Phone #Business Phone #PARTNER INFORMATION #2Partner Name and TitlePersonal Credit Score% OwnershipHome AddressCity, State, ZipSSN#Date of BirthCell Phone #Business Phone #PARTNER INFORMATION #3Partner Name and TitlePersonal Credit Score% OwnershipHome AddressCity, State, ZipSSN#Date of BirthCell Phone #Business Phone #BUSINESS TRADE REFERENCESBusiness NameContact Person & TitlePhoneBUSINESS PROPERTY INFORMATIONLandlord/ Bank ContactPhoneDo you lease or own: (briefly explain)ADDITIONAL INFORMATIONCurrent Credit Card Processing Company & Business BankGross Monthly Revenue: (Cash Monthly and Credit Monthly)Monthly Credit CardMonthly CashMonthly TotalAre you current on Sales Taxes?YesNoRadioOption 1Option 2Are you current on Payroll Taxes?YesNoAre you current on Property Taxes?YesNoAny Bankruptcies?YesNoPartner?YesNoIs your business for sale?YesNoAre you a US Citizen/Permanent Resident Alien? (Owner)Are you a US Citizen/Permanent Resident Alien? (Partner)Any Federal or State Tax liens of judgements? (Owner)Any Federal or State Tax liens of judgements? (Partner)Authorizaon: The Owner(s)/Officer(s)/Partner(s) (individually, an “Applicant”) idenfied on this applicaon, each represents, acknowledges, and agrees that (1) all informaon and documents provided to Cash Advance Funding, LLC, including but not limited to credit card processor statements, bank statements, ID, IRS documentaon, etc., are true, accurate, and complete (2) Applicant will immediately nofy Cash Advance Funding, LLC, of any change in such informaon and any change in financial condion (3) Applicant authorizes Cash Advance Funding LLC, to disclose all informaon and documents that Cash Advance Funding, LLC may obtain, including credit reports to other persons or enes collecvely, “Assignees”) that may be involved with or acquire commercial funds having daily repayment features or purchase of future receivables with a Merchant Cash Advance, including without limitaon the applicaon therefor potenal Transacons. (4) each Assignee will rely upon the accuracy and compleon of such and informaon and documents, (5) Cash Advance Funding, LLC, Assignees, and each of their representaves, successors, assigns, designees (collecvely “Recipients”) are authorized to request and receive invesgave reports, credit reports, statements from creditors, and financial instuons, also, verificaon of informaon, or any other informaon that a recipient deems necessary, (6) Applicant waives and releases any claims against Recipients and any informaon – providers arising from any act or omission relang to the requesng, receiving, or release of informaon, an (7) each Owner/Officer/Partner represents that he or she is authorized to sign this applicaon on behalf of Merchant Signature of Corporate Officer/OwnerStart signing your signature hereYour browser does not support e-Signature field.Print NameDateSignature of PartnerStart signing your signature hereYour browser does not support e-Signature field.DatePrint NameSubmit
