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Merchant Information (Please Complete All Information Below Accurately)
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BUSINESS INFORMATION
–
Step
1
of 6
Legal Name of Business
*
DBA Name of Business
Type of Business
Address
*
Address Line 1
Address Line 2
City
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
*
FAX
Email Address
*
Website / URL
Next
Legal Form of Entity & Authorized Signer (Please Check Box and Complete as Indicated)
Corporation Information (If Applicable)
Corporation
Name of President
First
Last
Name of Officer Signing Application
First
Last
Title
LLC Information
LLC
Name of Manager/Managing Member (Must Be Signer of Application)
First
Last
Partnership Information
Partnership
Name of General Partner (Must Be Signer of Application)
First
Last
Sole Proprietorship (Must Be Signer of Application)
Sole Proprietorship
Sole Proprietorship
First
Last
Date of Organization
State of Organization
Federal Tax ID#
Do you have Partners
Yes I have Partners
Partner Name One
First
Last
Partner Name Two
First
Last
Partner Name Three
First
Last
Partner Name Four
First
Last
Address (if different)
Address Line 1
Address Line 2
City
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
Cell Phone
FAX
How Long Have you Owned the Establishment?
Number of Employees
Number of Additional Locations Under Same Legal Corporate Entity
Has the Business Owners Ever Filed for Bankruptcy?
*
Yes
No
If Yes, When?
Name of Landlord (if applicable)
First
Last
Landlord Phone
Next
Total Annual Credit Card Sales?
Total Annual Sales?
Number of Seats (For Restaurant Owners)
Cuisine Type
Banking Institution for Business Account(s)
Has this bank been open for at least 90 days?
Yes
No
Is Your Business Seasonal?
Yes
No
% Sales Decrease In Low Volume Months
List Low Volume Months
Next
Cash Needs (Minimum of $5,000 up to a Maximum of $500,000 Based Upon Approved Credit)
Total Cash Needed
*
Date Cash is Needed?
*
Weekly Payment You Can Afford?
*
Cash Will Be Used For (Please check one or more)
*
Expansion
Renovations
Equipment
Inventory
Open Another Location
Cash Flow
Pay Taxes
Marketing
Pay Off Existing Advance
Other
Other
Existing Cash/Financing Providers
Name of Cash Provider
First
Last
Current Balance
Amount Funded
Date Funded
Do You Want to Pay Them Off?
Yes
No
What is your Current Interest Rate? (Please send us the most current statement on your account if you want to pay off this cash provider).
Upload your 3 Most Current Bank Statements Here and Year to Date Profit & Loss
Click or drag files to this area to upload.
You can upload up to 3 files.
Business Name
Name of 2nd Cash Provider
Current Balance with 2nd Cash Provider
Amount Funded
Date Funded
Do You Want to Pay Them Off? (copy)
Yes
No
Rate
Please Provide Your Most Current Statement Balance to be Paid Off
Click or drag a file to this area to upload.
Next
Information on Loan Guarantor (Required)
Name of Guarantor
First
Last
Date of Birth
Social Security Number
Drivers License Number
Address
Address Line 1
Address Line 2
City
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
Email
*
Email
Confirm Email
Phone
Do you Own or Rent?
Own
Rent
How Long?
Do You Currently Have Collection Issues Pending?
Yes
No
Agreement
I hereby give permission to Biz Cheddar Capital Resources, LLC, or any agent or credit-reporting agency that it may designate, to obtain any and all information concerning my assets and other credit matters, which they may require in connection with this credit Application. I specifically acknowledge and agree that (1) all statements which I have made in this Application are made for purposes of obtaining the financing, (2) verification and reverification of any information which I have supplied in connection with this Application may be made at any time by Biz Cheddar Capital Resources either directly or through a credit reporting agency, from any source named in this Application and the original copy of the Application will be retained by Biz Cheddar Capital Resources, even if the financing is not approved, (3) Biz Cheddar Capital Resources will rely on the information which I have supplied herein and I have the continuing obligation to amend and/or supplement that information if any of the material facts which I have represented should change prior to the total obligations under the credit Agreement being paid in full and (4) each Guarantor, upon request from time to time by Biz Cheddar Capital Resources, will provide Biz Cheddar Capital Resources with financial statements and such other information as Biz Cheddar Capital Resources deems appropriate, all in form and detail satisfactory to Biz Cheddar Capital Resources. This Application is part of a credit review process and additional information may be required. Biz Cheddar Capital Resources may render a credit decision on this application or may elect to submit this Application to one or more banks on the applicant’s behalf and any institution considering this Application shall make its own credit decision regarding this Application. The sales representative submitting this Application cannot extend credit or commit to any financing or funding until a credit decision has been made by the appropriate institution.
Checkboxes
*
Yes, I Agree to Electronic Consent
Next
Signature of Business' Authorized Signer & Loan Guarantor
Electronic Signature & Credit Authorization (Type your name in)
*
Date
*
Business Authorized Signer's Title
Completion and Signature Information
Bank Statements
Contact Preference
Business Phone
Cell Phone
Home Phone
E-Mail
Business Fax
Submit