Multiple Financial Services
Loan Application

If you are applying for individual credit in your name and are relying on your own income or assets and not the income of assets of another person as the basis for repayment complete Owner Information (1) and omit Owner Information (2).

If this is an application for joint credit with another person, complete Owner Information (1) and (2).

Date *

Intended Use of Funds *

Company Information

Legal Company Name *

Physical Business Address (No P.O. Boxes)

Company Phone *

Business Inception Date *

Type of Business *

State of Incorporation *

Federal Tax ID *

Approximate Credit Score *

Does your business have a separate bank account? *

Yes

Has your business accepted credit cards for at least 3 months? *

Yes

Do you have an outstanding merchant cash advance?

Yes

If you do have an outstanding merchant advance, with who and how much? *

Company Type/Industry *

Rent or Own? *

Rent

Own

If renting, landlord name and contact info *

When does your business need funding? *

Estimated Flow Overview

Annual Business Revenue *

Previous Average Bank Balance *

Monthly Credit Card Volume *

Average NSF Past 4 Months *

Loan Amount Requested *

Owner (1) Information

Full Name *

Email *

Cell Phone *

Home Phone

Annual Income *

SS Number *

Date of birth *

Address *

City *

State *

Postal code *

Business Ownership % *

Owner (2) Information

Full Name

Cell Phone

Home Phone

SS Number

Annual Income

Date of Birth

Address

City

State

Postal Code

Business Ownership %

Signature

(WE) HEREBY AUTHORIZE MULTIPLE FINANCIAL SERVICES, LLC AND/OR ANY OF ITS DESIGNEES OR ASSIGNEES TO MAKE WHATEVER CREDIT INQUIRIES IT DEEMS NECESSARY IN CONNECTION WITH MY CREDIT APPLICATION OR IN THE COURSE OF REVIEW OR COLLECTION OF ANY CREDIT EXTENDED IN RELIANCE UPON THIS APPLICATION AND I AUTHORIZE AND INSTRUCT ANY PERSON OR CONSUMER REPORTING AGENCY TO COMPILE AND FURNISH ANY INFORMATION IT MAY HAVE OR OBTAIN IN RESPONSE TO SUCH INQUIRIES. I (WE) ALSO CERTIFY THAT MULTIPLE FINANCIAL SERVICES, LLC MAY RELY UPON THIS AND ALL INFORMATION HEREIN AND OTHERWISE PROVIDED FOR LOAN EVALUATION.

Applicant Signature *

Clear

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