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1
Personal Information
2
Business Information
3
Funding Details
4
Legal Authorization, Uploads & Signature
Business Owner/Primary Contact Name
*
First
Last
Date of Birth
*
Social Security Number
*
Contact Email Address
*
Percentage Of Ownership
*
Mobile Phone Number*
*
Office Phone Number
*
Home Phone Number
*
Home Address
*
Address Line 1
Address Line 2
City
--- Select state ---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Have a Partner?
Add a Partner
Partner Name
*
First
Last
Partner Date of Birth
*
Partner Social Security Number
*
Partner Home License
Partner Email Address
*
Partner Percent of Ownership
*
Partner Mobile Phone Number
*
Partner Home Phone Number
*
Partner Home Address
*
Address Line 1
Address Line 2
City
--- Select state ---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Next
Business Name
*
Business Address
*
Address Line 1
Address Line 2
City
--- Select state ---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Business Phone Number
*
Business Tax ID Number
*
Description of Business/Number of Employees/ Years In Business
*
Monthly Business Revenue (USD)
*
Years in Business
*
Type of Industry
*
Date Business Established
*
Next
Funding Amount Requested (USD)
*
Purpose of Funding
*
Working Capital
Equipment Purchase
Inventory
Expansion
Debt Consolidation
Other (please specify)
Merchant's Combined Outstanding MCA Total Balance
*
Current MCA Funders' Names & Existing Balances
*
Next
Authorization: The Owner(s)/ Officer(s)/ Partner(s) (individually, an “Applicant”) identified on this application, each represents, acknowledges, and agrees that (1) all information and documents provided to MERCHANT TREND FUNDING (MTF), including but not limited to credit card processor statements, bank statements, ID, IRS documentation, etc., are true, accurate, and complete (2) Applicant will immediately notify MERCHANT TREND FUNDING (MTF) of any change in such information and any change in financial condition (3) Applicant authorizes Merchant Trend FUNDING to disclose all information and documents that MERCHANT TREND FUNDING (MTF) may obtain, including credit reports to other persons or entities (collectively, “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 limitation the application therefor (collectively, “Transactions”) and each Assignee is authorized to use such information and documents, and share such information and documents with other Assignees, in connection with potential Transactions. (4) each Assignee will rely upon the accuracy and completion of such and information and documents, (5) MERCHANT TREND FUNDING (MTF), Assignees, and each of their representatives, successors, assigns, and designees (collectively. “Recipients”) are authorized to request and receive investigative reports, credit reports, statements from creditors, and financial institutions, also, verification of information, or any other information that a recipient deems necessary, (6) Applicant waives and releases any claims against Recipients and any information – providers arising from any act or omission relating to the requesting, receiving, or release of information, and (7) each Owner/ Officer/ Partner represents that he or she is authorizes MERCHANT TREND FUNDING (MTF) to obtain any /all information about ( collectively, "the business" ) owner/partners for purposes of and not limited to underwriting and potentially securing a Cash Advance for "the business".
Please type the initials of the "owner/partners" in the box below
↓
Signature (please sign below owner and partner)
*
Clear Signature
Date of Application
*
Upload Last Three Months Bank Statements
*
Drag & Drop Files,
Choose Files to Upload
You can upload up to 5 files.
Upload Business Voided Check
*
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Choose Files to Upload
You can upload up to 5 files.
Upload Copy of Driver's License
*
Drag & Drop Files,
Choose Files to Upload
You can upload up to 5 files.
Submit