Business Legal Name (Merchant):
Business DBA Name:
City, State, Zip:
Legal Entity: Legal EntityCorpSole PropLLCPartnershipother
Federal Tax ID #:
Business Start Date: Business Start Date
How many business do you currently own?
# of Existing Cash Advance?
Average Gross Monthly Sales: $
Have you ever had cash advance judgment?
Is your business a seasonal business? Seasonal Business
Have you or any of the current owner/s ever filed for bankruptcy? If so, when? What was the conclusion- discharged or dismissed?
Owner Principal Information
Home City, State, Zip:
Business City, State, Zip:
% of Ownership:
Date of Birth:
2nd Principal Information
By signing below, the Merchant and its owners/principals: (1) certify that all information and documents submitted with the Application is true, correct and complete; (2) authorize Chrome Capital Funding and its agents, partners and funder to pull credit reports and any criminal or civil background report and any other information regarding the Merchant and principals directly or from third parties, to verify any information provided on the Application.
Leave this empty:
Your legal name
Your email address
If you have questions about the contents of this document, you can email the document owner.
Document Name: Credit Application
Agree & Sign