Form

Personal Information
Name*
Date of Birth*
Month Day Year
SSN*
Email*
Marital Status*
Spouse Name*
Phone Number*
Mobile*
Address*
City*
State*
Zip Code*
Financial Information:
Amount Requested*
Purpose*
How did you hear about Lyric Financial or FastForwardMyRoyalties?*
If you answered 'Other' above, please specify here
Royalty Information:
In the space(s) below, please provide information on your royalties, specifyingRoyalty Source, Account Name, and Account Number for each:
1:
2:
3:
Certification & Authorization to Release Information: (check the box at right and type initials below):*

I certify that I am authorized to make this application and to the best of my knowledge and belief, all information contained in this loan application and in the accompanying statements and documents is true, complete, and correct. I authorize Lyric Financial LLC and/or its affiliate companies to request and receive any and all information it deems necessary without further notice including credit history, account information and earnings history from any and all sources.
PLEASE CERTIFY AND AUTHORIZE BY TYPING YOUR INITIALS HERE:*
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Personal Information