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Loan Application

Business Information

First Name:

Last Name:

Business Legal Name:

Doing Business As (DBA):

Business Phone:

Business Address:

State:

Legal Entity Type:

Website:

Industry Type:

Business Start Date:

Primary Email:

City:

Zip:

Business Financial Information

Annual Revenue:

Desired Product:

Use of Proceeds:

Existing Loans:

Federal Tax Identification Number:

Desired Funding Amount:

Lender Name:

Current Balance:

Primary Owner Information

First Name:

Last Name:

Personal Address:

City:

State:

Zip:

FICO Score:

Social Security No:

Ownership %:

Date of Birth:

Mobile Phone Number:

Email:

Secondary Owner Information

First Name:

Last Name:

Personal Address:

City:

State:

Zip:

FICO Score:

Social Security No:

Ownership %:

Date of Birth:

Mobile Phone Number:

Email:

By signing below, each of the above listed business and business owner(s) identified above (individually and collectively, the "Applicant") represent, acknowledge and agree that: (1) all information and documents submitted in connection with this Application is true, accurate and complete; (2) you authorize Creditfy, LLC ("Creditfy"), and its affiliates, agents, partners and lenders ("Recipients") to obtain and receive consumer or personal, and business or entity, credit reports from one or more credit bureaus, such as Experian, Equifax or TransUnion and other information about you, including bank statements and other financial information from third party data providers, banks and creditors. You agree and authorize Creditfy to transmit and share all information and documents obtained, including credit reports (the "Application"), to any or all of the Recipients or other similar sources for the purpose of considering the Applicant’s request for financing. You waive and release any claims or liability against Creditfy and its Recipients to whom obtained Applicants information and credit reports as described herein and any information arising from any act or omission relating to receiving or release of information. You acknowledge that any false statements may be considered as fraud. Further, you authorize Creditfy, or an agent acting on its behalf, authorization to receive email, call and/or send you text/SMS messages at the phone number(s) including your cellular number and to the email addresses provided above, using an automated telephone dialing system or other similar system for marketing and advertising purposes. This consent is effective even if the number(s) are registered on a federal or state Do-Not-Call list.

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Timestamp

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October 2, 2020 3:20 am EST

Loan Application Uploaded by Creditfy Funding - peter.arvenom+admin@gmail.com IP 161.142.154.99

Working Capital Application