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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? Yes No	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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August 22, 2022 1:59 pm EDT

iCapital Application - GENERAL Uploaded by iCapital Funding - support@icapitalfunding.com IP 24.188.8.122