1 Business Information Legal/Corporate Name Physical Address Rent or Own —Please choose an option—RentOwn City State Zip Federal Tax ID Date Business Started Telephone # Email Address Loan option(s) interested in? (you may select more than one) Merchant AdvanceLine of CreditPPPSBA LoanEquipment FinancingInvoice FactoringCommercial MortgageTerm Loan Next 2 Owner Information Owner First Name Owner Last Name Title Ownership % Home Address City State Zip SSN Date of Birth Home # Mobile Phone # Do you have a partner? YesNo BackNext 3 Partner Information You selected No partner on the previous step. Click Next to continue. Partner First Name Partner Last Name Title Ownership % Mobile Phone # Home Address City State Zip SSN Date of Birth BackNext 4 Submit & Additional Details Type of Entity? Sole ProprietorshipPartnershipLLCCorporationIndustryOther Please specify Is the business seasonal? YesNo Product/Service Sold Gross Annual Sales Current Cash Advance Company Name(s) and Current Balance(s) Upload: 4 most recent months of business bank statements (PDF/JPEG) Month 1 Month 2 Month 3 Month 4 By signing below, each of the above listed business owners/officers and the business entity itself: Authorizes Capitalize Loans and its partners to obtain, share, and verify information provided in this application, including contacting banks, creditors, and credit reporting agencies as necessary to evaluate financing eligibility. Consents to the procurement of consumer and/or business credit reports by Capitalize Loans and its partners in connection with this application and for ongoing account review. Certifies that all information provided is true and complete, and understands that any misrepresentation may result in withdrawal or denial of financing. Agrees that electronic signatures and communications shall carry the same legal effect as written documents. Owner Signature 2nd Owner Signature (if applicable) Back Business Information Owner Information Partner Information Submit How did you hear about us?OnlineEmailReferralCompany RepMailerSocial MediaOther Loan option interested in? *may select more than one Merchant AdvanceLine of CreditPPPSBA LoanEquipment FinancingInvoice FactoringCommercial MortgageTerm Loan Do you have a partner ? Yes No Type of Entity? Sole ProprietorshipPartnershipLLCCorporationIndustryOther Open judgements?YesNoOpen Bankruptcy?YesNo Tax liens?YesNoIs Business Seasonal?YesNo By signing below, each of the above listed business and business owner/officer (individually and collectively, “you”) authorize Capitalize Loans and each of its representatives, successors, assigns and designees (“Recipients”) that may be involved with or acquire commercial loans having daily repayment features or purchases of future receivables including Merchant Cash Advance transactions, including without limitation the application therefore (collectively, “Transactions”) to obtain consumer or personal, business and investigative reports and other information about you, including 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 also authorize Capitalize Loans to transmit this application form, along with any of the foregoing information obtained in connection with this application, to any or all of 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 Capitalize Loans and to each of the Recipients, on its own behalf. For Faster Approval. Attach your 3 most recent months of business bank statements. *Upload PDF or JPEG only Owner Signature 2nd Owner Signature
