 |
Funding Application
|
General Information
|
First Name:
|
Last Name:
|
Website:
|
Language preference:
|
Business bank account?:
|
Business Information
|
Legal Business Name:
|
DBA Name:
|
Federal Tax ID Number:
|
Business Structure:
|
Date Founded:
|
Industry Type Services Provided:
|
No. of Employees:
|
Business Address:
|
Financial Information
|
Annual Revenue:
|
Average daily bank balance:
|
Open business loans:
|
Company Name 1:
|
Current Balance:
|
Date of Funding:
|
Company Name 2:
|
Current Balance:
|
Date of Funding:
|
Funding Request
|
Requested Funding Amount:
|
Requesting Funding Term:
|
Purpose of Funding:
|
Need Funding By:
|
Ownership Information
|
First name:
|
Last name:
|
Birth Date:
|
Social Security Number:
|
Personal Credit Score:
|
Address:
|
US Citizen:
|
Percent Ownership (%):
|
By signing below, each of the above listed business and business owners/officers/members (individually and collectively, the “Applicant”) certifies that Applicant is authorized to submit this application on behalf of the above named business. Applicant certifies that all information and documents submitted in connection with this Application are true, correct and complete and may be relied upon by ZJOB, Inc. DBA CapFront (“CapFront”). Applicant authorizes CapFront to share this application and all supporting documentation with each of its representatives, successors, assignees, and designees including third party lenders and their servicers (collectively “Assignees”) to make inquiries, including but not limited, to: (1) obtaining consumer, 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) obtaining credit card processor statements and bank statements from banks, creditors and other third parties; )3) consenting to the release, by any credit or financial institution, of any information relating to Applicant, to CapFront and to each of the Assignees, on its own behalf; (4) transmitting this application form, along with any of the foregoing information obtained in connection with this application, to any Recipients; and (5) contacting you via e-mail, call and/or text-message at the e-mail address and/or phone number provided above, or at any e-mail address and/or phone number reasonably identified as belonging to you, including wireless numbers (if applicable), even if listed on a Do-Not-Call registry, using an automated telephone dialing system or other similar system with respect to this application, future-related commercial-financing opportunities and/or other lawful telemarketing purposes. This authorization shall be valid for one hundred twenty (120) days unless revoked in writing by Applicant.
