Huminsky - SuiteLogin.com

Application: Credit Line Hybrid

Step 1 of 4

Business Information
Legal Business Name*
DBA (Doing Business As)
Business Address*
Street Address City State ZIP Code
Business Phone*
EIN#*
Gross Annual Revenue*
Company Website
Date Business Established*
MM slash DD slash YYYY
Date Business Incorporated*
MM slash DD slash YYYY
State Business Incorporated*
Name of Bank your Business is with*
Average Bank Balance*
Entity Type*

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Business owner(s) information:
List any owner with over 50% ownership
Business Owners Name*
First Last
Title*
% of Ownership*
Cell Phone*
Home Phone
Owners Address*
Street Address City State ZIP Code
Email*
Household Income*
SSN#*
Date of Birth*
MM slash DD slash YYYY
Maiden Name*
Mother's Maiden Name*
Own or rent home?*
How long at current address?*
Previous Address
Street Address City State ZIP Code
US Citizen*
Military Service?*
Military Year Entered*
MM slash DD slash YYYY
Military Year Discharged*
MM slash DD slash YYYY
Military Branch*
Stocks or Bonds over 100k?*
Retirement Assets over 35k*
Bankruptcy within the past 10 years?*
Currently Guarantor on other business funding?*
Please describe your outstanding business financing
include the lender names
Describe any banks you have a negative relationship with?
Describe any real estate owned that isn't reflected on the owners personal credit report?
# of Additional owners*
Additional Owner 1 Information
Name
First Last
Position
% of Ownership
Address
Street Address City State ZIP Code
Additional Owner 2 Information
Name
First Last
Position
% of Ownership
Address
Street Address City State ZIP Code

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Signature
STATEMENT OF ACCURACY The statement made in this, documents submitted electronically, and documents attached to this application are true and accurate to the best of my/our knowledge and belief. AUTHORIZATION TO OBTAIN INFORMATION I/We authorize Business Finance Suite and its affiliates and agents or any third party funder selected by Business Finance Suite, and credit card processor including but not limited to, Integrated Resource Network (IRN), to obtain whatever information regarding employment, bank accounts, and/or outstanding credit (mortgage, auto, personal, home improvement, charge cards, credit unions, etc.) that Business Finance Suite deems to necessary in connection with this application or in the course of review or collection of any credit extended in reliance of this application. I/ We authorize and instruct any consumer credit agency, commercial credit reporting agency, government agency, taxing authority, business or person to compile and furnish to Business Finance Suite any such information regarding us or our businesses as may be requested by Business Finance Suite. I/We agree that such information, along with this application, shall remain Business Finance Suite’s property whether or not the application is approved. This authorization will be valid for a period of two years from the date below or as long as applicant has an outstanding balance with Business Finance Suite or its affiliates. You authorize Business Finance Suite to verify or check any of the information given including credit references, background information and employment and to obtain credit bureau reports as Business Finance Suite deems necessary. You agree to immediately update Business Finance Suite if there is any material change in the information provided in any application forms, ownership, officers, financial status, contacts or other information for as long as you or successor or related entities conducts business with Business Financial Suite or it’s affiliate. A photocopy of this authorization will be as valid as the original.
I understand that there is a success fee of 9.9% for each unsecured line approved. Typically this is paid by the borrower using the newly acquired business financing.
Signature*
Date
MM slash DD slash YYYY
Signature
Date
MM slash DD slash YYYY
Signature
Date
MM slash DD slash YYYY

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Application: Credit Line Hybrid

Step 1 of 4

Business Information

Business owner(s) information:

Additional Owner 1 Information

Additional Owner 2 Information

Financing Details

Signature

I understand that there is a success fee of 9.9% for each unsecured line approved. Typically this is paid by the borrower using the newly acquired business financing.