PLEASE SEND BACK WITH LAST 3 MONTHS BUSINESS BANK STATEMENTS TO: KAREEN@FASTBUSINESSFINANCIAL.COM OR FAX: (323) 347-6425


BUSINESS CONTACT INFORMATION

Legal company name


Business start date


DBA name

EIN | Tax ID

Number of owner(s)

 Sole proprietorship
 Corporation
 LLC
 Other 

Registered company address

Phone 

Fax

Annual business revenue ($ Ammount)

Description of business

Desired $ amount

Existing MCA

 
 Yes     No

Approx existing balance ($ Ammount)


With which company

Purpose of funding


 
 OWNER (1) INFORMATION

Business owner name


Social security # 

Credit score

Fax #

Home address

Ownership %

Date of birth

Home phone

Mobile #

E‐mail
 
OWNER (2) INFORMATION

Business owner name


Social security # 

Credit score

Fax #
​​​​​​
Home address


Ownership %

Date of birth

Home phone

Mobile #

E‐mail
 




LANDLORD CONTACT INFORMATION

 Rent    Own

Landlord contact name


Phone #

Rent | Mortgage payment

 

SIGNATURES 

Owner (1) Signature
Name and Title

Date
 
Owner (2) Signature
Name and Title

Date
 


By signing above, each of the above listed business and business owner/officer (individually and collectively, “you”) authorize [Fast Business Financial] (“FBF”) 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 FBF 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 FBF and to each of the Recipients, on its own behalf.