Apply for Business Funding | Falcon Equity Group

Business Information

Business Legal Name

Business DBA Name

Address

Street Address

Suite/ Floor

City

State / Province

Postal / Zip Code

Work Phone Number

Cell Phone Number

Fax Number

Website

Email

Federal EIN

Business Start Date

Entity

CorpSole PropLLCPartnership

Type

RetailWholesaleServiceInternet

Location

Store FrontOfficeHomeOther

Landlord Name

Landlord Phone Number

Products / Service Sold

Reason For Funding

How did you hear about us?

Financial Information

Avg Gross Monthly Sales

Avg Monthly Credit Card Sales

How much do you need to borrow?

Are you currently in bankruptcy?

YesNo

Do you have a tax lien?

YesNo

Have you used a cash advance before?

YesNo

Owner/Principal Information

Owner

Owner Name

First Name

Last Name

Owner Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Owner Phone Number

Owner Email

% Ownership

Owner Date Of Birth

Owner SSN

Owner Driver's License

Co-Owner

Every Co-Owner field is optional.

Co-Owner Name

First Name

Last Name

Co-Owner Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Co-Owner Phone Number

Co-Owner Email

Co-Owner % Ownership

Co-Owner Date Of Birth

Co-Owner SSN

Co-Owner Driver's License

Authorization and Signatures

By signing below, each of the above listed business and business owner/office (individually and collectively, "you") authorize Falcon Equity Group LLC, and each of its representatives, successors, assignees and designees ("Recipients") that may be involved with or acquire commercial loans having a daily repayment feature or purchase of future receivables including Merchant Cash Advance transactions, including without limitation and application therefor (collectively, "Transactions") to obtain consumer and/or personal, business and investigative reports and other information about you, including credit card processor 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 Falcon Equity Group, LLC to transmit this application form, with any of the forgoing information obtained in connection with this application, to any or all of the Recipients for the foregoing purpose. You also consent to the release, by any creditor or financial institution, of any information relating to any of you, to Falcon Equity Group, LLC. And to each of the Recipients, on its own behalf certify that all the information contained herein is complete, true and accurate.

Owner Signature

Sign with your mouse, trackpad or finger.

Owner Sign Date

Co-Owner Signature

Sign with your mouse, trackpad or finger.

Co-Owner Sign Date