Clone of 10dlc

Business Name*
E-mail*
example@example.com
Phone Number
Format: (000) 000-0000.
Privacy Policy: https://clearwaterbusinesscapital.com/privacy-policy/

Term of Service: https://clearwaterbusinesscapital.com/term-of-service/
Business Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Industry Type*
Federal Tax ID*
Business start date under current ownership*

MonthDayYear
Date
State of Incorporation or Organization*
What type of loan are you interested in?*
How much capital do you need?*
How soon do you need funding?*
YesNo
Lender Name & Balance
Lender Name & Balance
Lender Name & Balance
Merchant/Owner Information
Name*

First NameLast Name
Title*
Ownership Percentage
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
SSN*
Credit Score*
Date of Birth*

MonthDayYear
Date
Second Owner's Information
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
SSN
Date of birth

MonthDayYear
Date
Please Upload The Last 4 Months of Statements
Bank Statement 1 (PDF)

Cancelof
Bank Statement 2 (PDF)

Cancelof
Bank Statement 3 (PDF)

Cancelof
Bank Statement 4 (PDF)

Cancelof
By signing, each of the above listed businesses and business owner/officer (individually and collectively, "you") certify that all information and documents submitted in connection with this application are true, correct and complete. You authorize (Clearwater Business Capital INC) and each of its representatives, successors, assigns and designees ("Recipients") that may be involved with or acquire commercial business loans having daily/weekly repayment features or purchases of future receivables including Revenue-Based Financing transactions, including without limitation the application therefor (collectively, "Transactions") to: (1) obtain consumer and/or personal, business and investigative reports and other information about you, including credit pulls (hard or soft), from one or more consumer reporting agencies, such as TransUnion, Experian and Equifax; (2) obtain credit card processor statements and bank statements, from, banks, creditors and other third parties; (3) transmit this Application, with any of the foregoing information submitted/obtained in connection with this application, to any or all of the Recipients for the foregoing purposes; (4) the release, by any creditor or financial institution, of any information relating to any of you, to (Clearwater Business Capital INC) and to each of the Recipients, on its own behalf. You intend to sign this Application electronically and consent to transacting business with (Clearwater Business Capital INC) and its affiliates electronically. You understand that consent to conduct business via electronic signatures and you may opt-out by contacting (Clearwater Business Capital INC) at chris@cbcsls.com. Your signature above certifies that you are authorized to sign this application on behalf of the Business and all the information contained herein is complete, true and accurate. Your mobile information will not be sold or shared with third parties for promotional or marketing purposes.
Signature*

Clear
Should be Empty:

Merchant/Owner Information

Second Owner's Information

Please Upload The Last 4 Months of Statements