Business cash advance and merchant funding

Business Cash Advance, Receivables Factoring, an alternative to Small Business Loans
	Speak to a Funding Specialist


Apply and get a 24 our to Same Day Approval.		Get your funds up to $200,000 per location wired directly into your business checking account in 3-5 days.		Repayment is easy. You never have to write us a check. A small portion is deducted from your daily credit card batches.

Merchant Application

Business Information

Legal Corporate Name:

DBA:

Physical Address:

City:

State:

Zip:

Business Telephone: () - ext.

Fax: () -

Federal Tax ID:

Contact Person:

Email Address:

Website:

Date Business Started:

Length of Ownership:

Years at Location:

# of Locations:

Ownership

Owner Name #1:

Home Phone: () -

Cell Phone: () -

Home Address:

City:

State:

Zip:

Date of Birth:

SSN:

Driver License:

State:

% Own:

Title:

Owner Name #2:

Home Phone: () -

Cell Phone: () -

Home Address:

City:

State:

Zip:

Date of Birth:

SSN:

Driver License:

State:

% Own:

Title:

Bank Information

Name of Bank:

Address:

Contact:

Phone: () - ext.

Landlord

Landlord Name:

Contact:

Cell #: ()

Work #: ()

Fax #: ()

Trade Suppliers

Business Name:

Contact:

Phone #: () -

Business Name:

Contact:

Phone #: () -

Business Name:

Contact:

Phone #: () -

Business Profile

Applicant authorizes 1st Merchant Funding, its assigns, agents, banks or financial institutions to obtain an investigative or consumer report from a credit bureau or a credit agency and to investigate the references given on any other statement or data obtained from applicant. Applicant, by signing below, represents that all the information is complete and accurate.

Name:

Date:

			Company \| Qualifications \| FAQ \| Site Map \| Contact \| Home