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By signing below, each of the above listed business and business owner/officer (individually and collectively, "you") authorize Biz Fund Network 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 Revenue Based Financing transactions, Including without limitation the application therefor (collectively, "Transactions") to obtain consumer and/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 Biz Fund Network to transmit this application form, with any of the foregoing information obtained in connections with this application, to any or all of the Recipients for the foregoing purposes. Youalso consent to the release, by an creditor or financial institution, of any information relating to any of you, to ME Capital and each Recipient, on its own behalf.
First Name:
Last Name:
Email Address:
Phone Number:
Potential Total Amount: [$5000 Up To $1,000,000]
Date Of Birth: [Select Your Date Of Birth]
Type Of Loans: Select Loan TypePersonalBusinessMerchantInvestmentCommercialOthers
Home Address:
Business Address:
How Long Have Been In Business: Select Time in Business6-12 months1-2 years2-3 years3-4 years5-6 years6-7 years7-8 years8-9 years9-10 years10 years+
Monthly Income:
Note If Need (Optional):
