Apply Online - Loanability

Business Information

Business Legal Name*

Doing Business As Name

Type of Business Entity*

Business Tax ID #*

State of Incorporation

Use of Proceeds

Physical Address (Not PO Box)*

Street Address Address Line 2 City State ZIP Code

Physical Location Phone

Billing Location Phone

Preferred Contact Phone*

Email*

Industry Type*

Physical Location*

Rent
Own

Rent Amount

Gross Annual Sales*

Date of Business Ownership*

Bank Deposits

Has there been more than 5 days per month where your business bank account ended with a negative balance over the past 3 months?*

Deposits Last Month*

Deposits Two Months Ago*

Deposits Three Months Ago*

Visa/MasterCard Processing Volume

Do you accept Visa/MC for payment?*

Yes
No

Average Monthly Visa/MC

Visa/MC Last Month

Sales Tickets

Visa/MC Two Months Ago

Sales Tickets

Visa/MC Three Months Ago

Sales Tickets

Visa/MC Four Months Ago

Sales Tickets

Owner/Officer Information

First Name*

Last Name*

Title

Date of Birth*

SSN*

Home/Cell Phone

Home Address*

Street Address Address Line 2 City State ZIP Code

Authorizations

By signing below, each of the above listed business and business owner/officer (individually and collectively, “you”) authorize Loanability, Inc. (“Loanability”) 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 therefore (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 Loanability 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 Loanability and to each of the Recipients, on its own behalf.

Signature*

Name*

First Last