Apply Now – Cheddar Capital

BUSINESS INFORMATION

Business Legal Name*

Business DBA Name*

Type of Business Entity*

Corportation
Sole Proprietorship
LLC
Partnership

Business Location*

Store Front
Office
Home
Other

Physical Address*

City*

State*

Zip*

Business Phone*

Business Fax

Mobile Phone

Business Email*

Current Website:

Type of Business / Products Sold:*

Federal Tax ID #:*

Business Start Date (MM/DD/YY):*

Business Property Ownership*

Lease
Own

Rent / Mortgage Payment:

Lease Start Date

Lease End Date

Landlord / Mortgage Company:

Landlord / Mortgage Contact Name:

Mortgage / Landlord Company Phone:

Mortgage / Landlord Company Email:

OWNER / PRINCIPAL INFORMATION

Owner Name:*

% of Ownership*

Home Address:*

Home City*

Home State*

Home Zip*

Home Phone:*

Home Fax:

Email Address*

Mobile Phone*

Date of Birth*

Social Security Number*

PICTURE OF DRIVERS LICENSE:

Drop files here or

OWNER / PRICIPAL INFORMATION #2

Owner Name:

% of Ownership

Home Address:

Home City

Home State

Home Zip

Home Phone:

Home Fax:

Email Address

Mobile Phone

Date of Birth

Social Security Number

PICTURE OF DRIVERS LICENSE:

Drop files here or

FUNDING INFORMATION

Desired Loan Amount:*

Purpose Of Loan:*

Annual Sales Previous Calendar Year:*

Projected Annual Sales Current Year:*

Requested Payback Time:*

Please enter a number from 3 to 60.

Preferred Payback:*

Daily
Weekly
Monthly

Current Loan*

Yes
No Current Loan

Balance of Current Loan*

Lender Name:*

Bank Statements

Bank Statements Upload

Drop files here or

Signatures

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, its agents, partners, and lenders to receive 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. By signing this agreement, the Merchant hereby authorizes Cheddar Capital and its affiliates to obtain the 12 most recent monthly reports detailing Merchant’s credit card processing activity from its card processor or any agent or other third party utilized by that processor to authorize, clear and/or settle credit card payments.

Owner Signature*

Co-Owner Signature

Owners Name*

First Last

Co-Owners Name

First Last

Email

This field is for validation purposes and should be left unchanged.

BUSINESS INFORMATION

OWNER / PRINCIPAL INFORMATION

OWNER / PRICIPAL INFORMATION #2

FUNDING INFORMATION

Bank Statements

Signatures

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