Working Capital Working Capital Please complete the loan application form below to submit your loan application online. Your application is secure and we do not share any of your information.Business InformationLegal Business Name* Business DBA Name Type of Business Entity (Check One) Corporation Partnership LLC LLP Ltd Partnership Sole Proprietor Primary Business Structure (Check All That Apply) Home-Based Business E-Commerce Franchise None of the Above Does the Merchant have any open MCA or loan accounts? (Check one) Yes No Federal Tax ID Industry Type (Describe)Current Credit Card Processor State of Incorporation AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Use of Proceeds Business start date under current Ownership Month Day Year Merchant Email Address Physical Street Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Billing Address (if different than above) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Preferred Contact Phone NumberBusiness Location(s) Rented Mortgaged Business Location(s)Average Monthly Credit Card VolumeAverage Transaction AmountGross Annual Sales (From previous year's Tax returns)List the Total Business Bank Deposits and # of Days with a Negative Balance (Last Month) Total Business Bank Deposits(Last Month) # of Days with a Negative Balance (Two Months Ago) Total Business Bank Deposits(Two Months Ago) # of Days with a Negative Balance (Three Months Ago) Total Business Bank Deposits(Three Months Ago) # of Days with a Negative Balance (Four Months Ago) Total Business Bank Deposits(Four Months Ago) # of Days with a Negative Balance Borrower InformationOwner/Officer is Primary Contact? Yes No Name* First Last Social Security Number* Date Of Birth* Month Day Year Email* Phone Number*Street Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code AuthorizationBy signing below, each of the above listed business and business owner/officer (individually and collectively, "you") authorize Sully Knows Financing ("SKF"), 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 SKF 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 SKF and to each of the Recipients, on its own behalf.Borrower's Signature*Borrower's Name* First Last Additional InformationMerchant Cell Phone #Merchant Fax #Merchant Web Address Landlord Name First Last Landlord Contact #Is Your Business Seasonal? Yes No If yes, what are the peak months? Any Judgments/Liens? Yes No Any Open Bankruptcies? Yes No Second Owner Name First Last Second Owner % Ownership Business Trade ReferencesReference #1 Reference Phone #Reference #2 Reference Phone #Reference #3 Reference Phone #In order to process your application, we will also require the last three (3) months of business bank statements. Please upload this information below, or you may send it directly to our office by email at sullyknowsfinance@gmail.com, or by Fax at (888) 557-0993. For any additional questions, please contact our office at (678) 799-1349.Business Bank Statement Upload Drop files here or Select files Max. file size: 512 MB.
