Apply — Business Loan Application

I. Business Information

Business Name *

Business Phone

Business Address street, city, state, ZIP

EIN # XX-XXXXXXX

Email *

Business Structure

LLC Corporation Partnership Sole Proprietorship Other

Years in Business

Avg. Monthly Bank Deposits

Annual Revenue

II. Applicant / Owner Information

Full Name *

Title / Role

Ownership %

Personal Cell

Date of Birth

Social Security Number * Required for credit underwriting. Transmitted securely.

Home Street Address

City

State

Zip Code

III. Ownership Structure

How Many Owners Does the Business Have? * If more than one, add each additional 25%+ owner below.

Beneficial Ownership Information (25%+ Owners)

List any additional individuals with 25% or greater ownership (directly or indirectly), beyond the applicant/owner listed in Section II. If you are the sole owner, leave this section blank.

Owner 2

Name

SSN

Date of Birth

Residential Address

Ownership %

Owner 3

Name

SSN

Date of Birth

Residential Address

Ownership %

Owner 4

Name

SSN

Date of Birth

Residential Address

Ownership %

Owner 5

Name

SSN

Date of Birth

Residential Address

Ownership %

IV. Credit & Banking

Credit Score Range

720-850 680-719 640-679 620-639 580-619 550-579 350-549

Business Bank Name

Account Type

Checking Savings

VII. Referral & Additional Details

Where Did You Hear About Us? *

Google Search Referral / Word of Mouth Social Media Repeat Client Other

Additional Details Tell us about your business, what you need the capital for, and any other relevant details.

📎

Upload Bank Statements

Please upload your last 6 months of business bank statements (more is welcome). PDF, image, or spreadsheet files accepted. Max 10MB per file.

⬆️

Click or drag & drop bank statements

PDF, JPG, PNG, CSV, XLSX — select multiple files

VIII. Authorization & Consent

Signature (Type Full Legal Name) *

Date