Our Location
12555 Orange Drive, Suite 107 Davie, Florida 33330
Office Phone
(888) 708-0605
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Mon-Fri: 10 AM-8 PM
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Company Name
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Company Start Date
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Email
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Entity Type
*
Corporations
General Partnership
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Limited Partnership
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LLC
EIN/Tax ID
*
The EIN can be found on your business tax returns, IRS notices, bank statements or online
Does the Merchant have any Open MCA or Loan Accounts?
*
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If Yes Provide Details, If none, enter N/A
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Physical Business Address
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Phone Number if different than above
Business Locations
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Monthly Payment Amount
Next
Tell us about yourself
Are you the Primary Contact
Yes
Percentage Owned
Owner 1 - Officer 1 Email Address
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Owner 1/ Officer 1 Name
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SS#
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Date of Birth
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Residential Address
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Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
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Ohio
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Washington
West Virginia
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State
Zip Code
Next
Tell us the 2nd Owner, If none Skip This page
Percentage Owned by Owner 2
Owner 2 - Officer 2 Email Address
Owner 2 / Officer 2 Name
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Last
Second Owner SS#
Owner 2 Date of Birth
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Owner 2 Cell Phone
Owner 2 Home Phone
Owner 2 Residential Address
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Next
Is your business seasonal?
Yes
No
If yes what are the peak months?
Any Open Bankruptcies?
*
Yes
No
Any Judgements or Leans?
*
Yes
No
Business Trade Reference 1
Business Trade Reference Phone
Business Trade Reference 2
Business Trade Reference Phone 2
AUTHORIZATIONS - By signing below, each of the above-listed business and business owner officer (Individually and collectively, ''you*') authorize All Credit Funding ("ACP) each of its representatives, successors, assigns, and designee's ('Recipients') that may be involved with or acquire commercial financing having daily repayment features or purchases of future receivables including Payment Rights and Purchase Sale transactions, including without limitation the application therefor (collectively, 'Transactions') to obtain a consumer or personal, business and investigative or credit 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 ACF 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 AG and to each of the Recipients, on its own behalf.' Owners) and business (you-I) understand that if this business credit request is approved, your payment obligations can be made through ACH debits by lender/purchaser or its designee from your bank account By signing below, you hereby authorize lender,' purchaser or its designee to initiate an ACH test debit from the bank account designated below to confirm that if this credit request is approved, payment processing will proceed as agreed The test debit will be in a random amount but in no event more than S1.00.
OWNER 1: I Agree to the terms listed in this credit app.
*
Yes , I Agree
OWNER 2: I Agree to the terms listed in this credit app.
Yes , I Agree
Upload PDF copies of the last 3 months of your businesses bank statements below
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Upload PDF copies of the last 3 months of your businesses bank statements below
*
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Upload PDF copies of the last 3 months of your businesses bank statements below
*
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Upload a copy of your Driver's License
*
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Officer 1 Signature
*
Clear Signature
Officer 2 Signature
*
Clear Signature
Phone
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