Business Funding Application · Today's Advance

Legal Business Name *

What is the legal name of the business looking for funding?

Business DBA Name (If Applicable)

Does the business have any other trade name or d/b/a name?

Business Legal Structure

What is the legal structure of the business looking for funding?

State of Incorporation *

Where was the business incorporated?

Business Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Location Type

What kind of location does the business operate from?

Business Phone *

What is the main phone number of the business looking for funding?

Business Web Site

Does the business have a website?

Date Business Started *

When did the business looking for funding begin?

Business Tax ID *

What is the Federal Tax ID (EIN) of the business looking for funding?

Gross Annual Revenue *

What is the gross annual revenue of the business?

Funding Requested *

How much funding does the business need?

Use of Proceeds *

What does the business need funding for?

Industry Type *

What industry does the business operate in?

Principle Owner

Principle Owner Name *

First

Last

Principle Owner's Equity Percentage

Principle Owner Owns 100 %

Principle Owner Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Principle Owner Phone *

Principle Owner Email *

Principle Owner Date of Birth *

Principle Owner SSN *

Principle Owner Drivers License

Co-Owner

Co-Owner Name

First

Last

Co-Owner's Equity Percentage

Co-Owner Owns 0 %

Co-Owner Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Co-Owner Phone

Co-Owner Email

Co-Owner Date of Birth

Co-Owner SSN

Co-Owner's Drivers License

Trade References

Trade Reference 1 Company

Reference 1 Contact

First

Last

Reference 1 Phone

Trade Reference 2 Company

Reference 2 Contact

First

Last

Reference 2 Phone

Trade Reference 3 Company

Reference 3 Name

First

Last

Reference 3 Phone

Real Estate Expenses

Landlord or Mortgage Holder

Contact Person

First

Last

Contact Number

Monthly Rent or Mortgage Payment

File Upload *

Click or drag files to this area to upload. You can upload up to 8 files.

Please submit 3 months of bank statements and any other documents requested by your Today's Advance Funding Specialist

Principle Owner Signature *

By signing below, the Merchant and its owners/ principals (1) certify that all information and documents submitted in connection with this Application is true, correct and complete; and (2) authorize Today's Advance and each of its representatives, successors, assignors and designees ('Recipients') to request, receive, and/or obtain credit reports and any other information regarding the Merchant and its owners and principals from third parties, to verify any information provided on the application.

Co-Owner Signature

By signing below, the Merchant and its owners/ principals (1) certify that all information and documents submitted in connection with this Application is true, correct and complete; and (2) authorize Today's Advance and each of its representatives, successors, assignors and designees ('Recipients') to request, receive, and/or obtain credit reports and any other information regarding the Merchant and its owners and principals from third parties, to verify any information provided on the application.

Your Today's Advance Funding Specialist *

If you're working with a Today's Advance Specialist, please select them from this list to ensure that they are included on all automated communications.