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Business Information:

Legal Name:

Operating As:

Business Address:

Website:

Date Established:

Entity Type:
CorporationSole ProprietorshipPartnership

Ownership Information:

First & Last name

Home address: 

Date of birth:

SIN: (Optional)

Mobile:

Email: 

Are you the majority owner?
YesNo

Disclaimer: 
SIGNATURES - ALL OWNERS MUST SIGN -- By signing below, the Merchant and its owner(s) certify that all information and documents submitted in connection with this Application are true, correct and complete.
Additionally, the owner(s) authorize the Funder to obtain and use business and non-business consumer credit reports from credit reporting agencies and any other information regarding the Merchant and its owner(s) from third parties, both at the time of the initial funding application and at any time after the Merchant has received funding as long as the Merchant remains a client of the Funder. At all times, the Funder will comply with the personal information collection, protection, use, sharing, and retention practices set out in the Funder's Privacy Policy.

Check Box to accept the disclaimer and privacy policy