Business Funding Application

A. Business Information

Business Legal Name (Merchant)*

Business DBA Name

Street Address

City

State

Zip

Phone*

Mobile

Email*

Website

Federal / State Tax #

Legal Entity

Corp Sole Prop LLC Partnership

Business Location

Store Front Office Home Other

Date Business Started

Industry

Is your business seasonal?

Yes No

C. Owner / Principal Information

Name*

Address

City, State, Zip

% of Ownership

Date of Birth

Credit Score

SSN #

Driver's License #

Owner #2 (If Applicable)

Name

Address

City, State, Zip

% of Ownership

Date of Birth

Credit Score

SSN #

Driver's License #

D. Funding Request

How much revenue per year?*

How much are you trying to get?*

Do you have any open positions/advances?*

Yes No

How many?*

Have you ever defaulted?*

Yes No

H. Certifications & Signature

I/We certify that the information provided in this application is true, complete, and accurate to the best of my/our knowledge. I/We authorize ThunderCap and its agents to verify all information, obtain credit reports, and communicate with banks, vendors, and references as part of the review process.

Authorized Signature (Owner #1)*

Date