Business Lending Application

1. Business information

Legal business name *

DBA

Entity type *

EIN / Tax ID last 4

Industry *

Years in business *

Business address *

City *

State *

ZIP *

Business website

Business email *

2. Owner / applicant

First name *

Last name *

Title *

Ownership % *

Email *

Phone *

Home mailing address

A lender may later require SSN, date of birth, photo ID and other verification through its secure process.

3. Funding request

Amount requested *

Primary use of funds *

Annual gross revenue *

Average monthly deposits *

Average monthly card volume

Approximate personal credit range

Existing business loans / advances?

Estimated monthly obligations

Any bankruptcy in the past 7 years?

Any active tax liens?

Describe the funding need and timing

4. Certifications & consent

I certify that the information provided is accurate and complete to the best of my knowledge.I authorize TRAK to share this application with prospective lenders, funding providers and related service providers as reasonably necessary to evaluate financing options.I authorize TRAK and prospective funding providers to contact me about this request using the contact information provided.I agree to the website terms and application authorization and understand that submission is not a guarantee of approval or funding.

Tell us where you want to grow.

1. Business information

2. Owner / applicant

3. Funding request

4. Certifications & consent