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Business Information

Required Section
Physical Address(Required)
Mailing Address(Required)
Business Category(Required)
Type Of Entity(Required)
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Merchant/Owner Information - Applicant

Required Section
Address(Required)
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Merchant/Owner Information - Applicant 2 (If Any)

Optional Section
Address
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Business Property Information

Required Section
Own/Rent(Required)
Credit Card Processing Method: (Must Equal 100%)
Authorization:

The Owner(s)/ Officer(s)/ Partner(s) (individually, an “Applicant”) identified on this application, each represents, acknowledges, and agrees that (1) all information and documents provided to US Advanced Capital, including but not limited to credit card processor statements, bank statements, ID, IRS documentation, etc., are true, accurate, and complete (2) Applicant will immediately notify US Advanced Capital of any change in such information and any change in financial condition (3) Applicant authorizes US Advanced Capital to disclose all information and documents that US Advanced Capital may obtain, including credit reports to other persons or entities (collectively, “Assignees”) that may be involved with or acquire commercial funds having daily repayment features or purchase of future receivables with a Merchant Cash Advance, including without limitation the application therefor (collectively, “Transactions”) and each Assignee is authorized to use such information and documents, and share such information and documents with other Assignees, in connection with potential Transactions. (4) each Assignee will rely upon the accuracy and completion of such and information and documents, (5) US Advanced Capital, Assignees, and each of their representatives, successors, assigns, and designees (collectively. “Recipients”) are authorized to request and receive investigative reports, credit reports, statements from creditors, and financial institutions, also, verification of information, or any other information that a recipient deems necessary, (6) Applicant waives and releases any claims against Recipients and any information – providers arising from any act or omission relating to the requesting, receiving, or release of information, and (7) each Owner/ Officer/ Partner represents that he or she is authorized to sign this application on behalf of Merchant.

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