iCapital Application - GENERAL


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BUSINESS INFORMATION
 Business Legal Name  Doing Business As
 Business Legal Entity
 Federal Tax ID  
 Business Phone Number    Business Start Date
 Physical Address    City, State, Zip Code  
Type of Business
PRIMARY OWNER INFORMATION
 Name    Date of Birth
 Mobile Number    Social Security Number  
 Home Address  
 City, State, Zip Code    % Of Ownership  
FUNDING INFORMATION
 Purpose of Funding    Amount Requested  
 Gross Annual Sales    Average Monthly Sales  
 Do You Have an Existing MCA or Business Loan? 

 If Yes, What is/are the Current Balance?  
By signing below, each of the above listed business and business owner/officer (individually and collectively, "you") authorize ICapital Cash Inc ("ICapital Funding") 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 therefor (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 ICapital Funding 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 Capital Funding and to each of the Recipients, on its own behalf.

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Signature Certificate
Document name: iCapital Application - GENERAL
lock iconUnique Document ID: 56bd32e83e6ddf5929b7c21f4901f30cda2fd65f
Timestamp Audit
August 22, 2022 1:59 pm EDTiCapital Application - GENERAL Uploaded by iCapital Funding - support@icapitalfunding.com IP 24.188.8.122