Small Business Loans
 1-888-572-6737
 1-888-572-6737

Application Form

MAIN: 1-888-572-6737

FAX: 1-888-813-2673

E-MAIL: info@smallbyzloans.com


Company/Legal Business Name: Doing Business As/DBA: Business Start Date:
Business/Physical Address (No PO Boxes): City: Zip:
Business Phone Number: Business Fax Number: Federal Tax ID: State of Incorporation:

Type of Business Entity:
Sole Proprietorship
Annual Gross Sales: Monthly Credit Card Volume: Product/Service Sold: Description of Business:

Principal Owner #1

First Name: Last Name: Title: Ownership %:
Home Address: City: Zip:
Social Security Number: Date of Birth: Owner #1 Email: Home Phone Number: Mobile Phone Number:

Principal Owner #2

First Name: Last Name: Title: Ownership %:
Home Address: City: Zip:
Social Security Number: Date of Birth: Owner #2 Email: Home Phone Number: Mobile Phone Number:

Business Property Landlord Reference

Do you rent or own?
 Lease Expiration Date:
Rent Amount $ per month
Are you current?
Landlord/Mortgage Co. Name: Contact Name: Contact Phone Number:
Requested Amount: Number of Employees: Credit Card Processing Co:

Current Funding Balance(s)

Lender: Org. Amount: Balance: Frequency Payment.Amt

By signing below, each of the above listed Business and/or Business owner/officer(s) (individually and collectively, “you the Business owner(s)”) authorize Equity Box, LLC., DBA (“SMALLBYZLOANS.COM”) and each of its representatives, successors, assigns and designees (“Recipients”) that may be involved with the acquisition of commercial loans to having daily repayment, weekly, bi-weekly, or monthly repayment schedules assigned to its representatives, successors, assigns and designees (“Recipients”) for loans secured behind the purchases of future receivables including Merchant Cash Advance transactions, including without limitation the application therefor (collectively,“Transactions”). “You the Business owner,” authorize the (“Recipients”) to obtain consumer or personal, Business and investigative reports and other information about you, including credit card processor statements and Business bank statements. “You the Business owner,” authorizes agencies such as TransUnion, Experian and Equifax, or other credit bureaus, banks, creditors and other third parties to release any and all information requested by (“Recipients”). “You the Business owner,” also authorizes Equity Box, LLC. 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.


Documents:

Principal Owner:
Print Name:
Date:
Principal Owner:
Print Name:
Date:

Digital Signature:

Owner#1 Signature


Digital Signature:

Owner#2 Signature


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