Comprehensive Business Funding Application
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First Name:*
Last Name:*
Email Address:*
Business Name:*
Phone Number:*
Average Monthly Revenue*
Select Average Monthly Revenue
Below $10,000
$10,000 to $30,000
$30,001 to $60,000
$60,001 to $100,000
$100,000 to $150,000
$150,001 to $300,000
Greater than $300,000
Calculate the average amount of deposits to your Business Bank account over the most recent three months.
Annual Gross Revenue*
Select Annual Gross Revenue
Below $50,000
$50,000 to $120,000
$120,001 to $350,000
$350,001 to $600,000
$600,001 to $1,000,000
$1M to $2M
Greater than $2M
Average Monthly Payroll*
Credit Score*
Select Credit Score Range
300 - 579
580 - 619
620 - 679
680 - 719
720 - 850
Years in Business*
Select Years in Business
0 - 3 Months
3 - 6 Months
6 - 12 Months
1 - 2 Years
2 - 3 Years
3 - 4 Years
4 - 5 Years
5+ Years
Industry: *
Choose One
Agriculture and farms
Amazon sellers
Auto repair shops
Cannabis
Child care centers
Construction
Consulting companies
E-commerce
Faith-based organizations
Food truck
Franchise
Gas station
Gym franchise
Home healthcare services
HVAC
Insurance agencies
Law firm
Liquor stores
Medical professionals
Nonprofits
Pharmacy
Physical therapy practices
Restaurants
Retail business
Salons and spas
Trucking
Vineyards and microbreweries
Yoga studio
Other
I am interested in applying for*
Choose One
All Term Loan & LOC Products
Line of Credit
Short Term Loan (6 to 36 months)
Round Up*
copy*
Product Code*
Product*
Source*
Source Code*
Platform*
Platform Code*
Site*
Site Code*
Template*
Template Code*
List*
List Code*
Marketed Email*
LeadIDLink*
Date*
/
/
Login*
Login Code*
Rep. Email*
Rep Name*
Number of Employees*
Notifcation*
State*
Choose One
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
Has your business filed for the ERC Credit with the IRS? (Using 941 or 941x Forms)*
Yes
No
How many quarters did you file for?*
Choose One
1
2
3
4
5
6
7
What is the ERC Credit Amount expected?*
When did you file for the ERC Credit?*
/
/
Closed Date*
Your form has been saved. You can complete it via this link within 60 days.
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PLEASE NOTE: We are not part of, or associated with, the United States Small Business Administration (the “SBA”), nor are we licensed by the SBA. We are not your loan broker or SBA lender. We may submit or help you with submitting your SBA loan application to one or more authorized SBA lenders. If one of the SBA lenders provides you with an SBA loan, which determination shall be made by the particular SBA lender, the SBA lender is solely responsible for the SBA loan, and you agree that we are not liable for any actions, claims, losses, damages fines, or expenses that you may incur related to the SBA loan. We are paid by the SBA lenders for our services.
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