Business Application
Business Details
Business Name:
*
Entity Name:
Business DBA:
DBA:
Business Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Federal Tax ID:
*
Business Start Date:
*
-
Month
-
Day
Year
Business Phone Number:
*
Business Email:
*
example@example.com
Industry:
Merchant Details
Merchant Name:
*
First Name
Last Name
Merchant Address:
*
Street Address
Street Address Line 2
City
Please Select
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
Phone Number:
Email:
john@example.com
Date of Birth:
*
/
Month
/
Day
Year
Social Security:
*
Ownership Shares %:
*
example: 100%
Credit Score:
*
2nd Owner Name
First Name
Last Name
2nd Owner Address:
Street Address
Street Address Line 2
City
Please Select
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
2nd Owner Phone Number:
2nd Owner Email:
john@example.com
2nd Owner Date of Birth:
/
Month
/
Day
Year
2nd Owner Social Security:
2nd Owner - Ownership Shares %:
example: 100%
2nd Owner Credit Score:
3 Months Bank Statements (NY, UT, VA, CA - 4 months bank statements)
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Signature
By signing below, each of the above-listed business and business owner/officer (individually and collectively, “you”) authorize Skycapnow LLC 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 therefor (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 Skycapnow LLC 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 Skycapnow LLC and to each of the Recipients, on its own behalf. You also authorize Skycapnow LLC and each of its Recipients to contact you via text message, automated call or email message at the contact information listed above.
Date
-
Month
-
Day
Year
Date
SUBMIT
SUBMIT
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