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Business Funding
Amount Requested*
Monthly Revenue*
Do you have existing loans?*
Annual Revenue*
How many owners are in the business?
Primary Owner Information
First Name*
Last Name*
Email*
Cell Phone*
Social Security*
% Ownership*
Date of Birth*
Street Address
ZIP Code
City
State
Business Information
Legal Business Name*
States DBA
Monthly Rent / Mortgage*
EIN*
Business Start Date*
Product / Services Sold*
Street Address
ZIP Code
City
State
Upload Bank Statements

This is needed to verify your application. You can upload PDF's.
September Month To Date
August Business Bank Statement
July Business Bank Statement
June Business Bank Statement
May Business Bank Statement
April Business Bank Statement
March Business Bank Statement
Signature
Primary Owner Signature*
By signing below, each of the above listed business and business owner/officer (individually and collectively, “you”) authorize” Dealstruck and each of its representatives, successors, assigns and designees (“Recipients”) that may be involved with or acquire commercial loans having daily repayment features or purchases of future receivables including Merchant Cash Advance transactions, including without limitation the application therefor (collectively, “Transactions”) to obtain consumer or personal, business and investigative reports and other information about you, including credit card processor statements 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 Dealstruck to transmit this application form, along with any of the foregoing information obtained in connection with this application, to any or all of the Recipients for the foregoing purposes. You also consent to the release, by any creditor or financial institution, of any information relating to any of you, to Dealstruck and to each of the Recipients, on its own behalf.

CONSENT TO TELEPHONE CALLS: You expressly consent to receiving marketing and other calls and messages, to landline, wireless or similar devices, including auto-dialed and pre-recorded message calls, and SMS messages (including text messages) from recipients, at telephone numbers that you have provided. Message and data rates may apply. Your consent to receive marketing calls is not required for your application, if you do not consent, do not provide your phone number.
CONSENT TO ELECTRONIC DISCLOSURE: You expressly consent to transactions and disclosures with recipients online and electronically. Disclosure will be provided to you either on the screen, on recipients' website or via electronic mail to the email address you provided.

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Business Funding

How many owners are in the business?

Primary Owner Information

Business Information

Upload Bank Statements

Signature