Merchant Agent

Email / User Name

Password

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Apply Now For A Business Cash Advance

Simply fill out our merchant cash advance application below. With our quick underwriting turnaround it typically takes less than 24 hours to receive a response along with your options. Funding takes typically 7 days from when you are approved.

Merchant Cash Advance Program Requirements:

You must process $3,500 or more per month in Visa/MasterCard & Discover

Current on your rent with your landlord as we do verify this with your landlord

No unresolved bankruptcies in the last year

Business Information
Legal/Corporate Name:
DBA:
Physical Address:
City:
State:
Zip:
Business Telephone:	( ) - ext.
Fax:	( ) -
Federal Tax ID:
Contact Person:
Email Address:
Website:
Date Business Started:
Length of Ownership:
Years at Location:
# of Locations:

Ownership
Owner Name #1:
Home Phone:	( ) -
Cell Phone:	( ) - ext.
Home Address:
City:
State:
Zip:
Date of Birth:
SSN:
Driver License:
State:
% Own:
Title:

Owner Name #2:
Home Phone:	( ) - ext.
Cell Phone:	( ) -
Home Address:
City:
State:
Zip:
Date of Birth:
SSN:
Driver License:
State:
% Own:
Title:

Bank Information
Name of Bank:
Address:
Contact:
Phone:	( ) - ext.

Landlord
Landlord Name:
Contact:
Cell #:	( ) -
Work #:	( ) -
Fax #:	( ) -

Trade Suppliers
Business Name:
Contact:
Phone #:	( ) -

Business Name:
Contact:
Phone #:	( ) -

Business Name:
Contact:
Phone #:	( ) -

Digital Signature
Applicant authorizes 1st Merchant Funding, its assigns, agents, banks or financial institutions to obtain an investigative or consumer report from a credit bureau or a credit agency and to investigate the references given on any other statement or data obtained from applicant. Applicant, by signing below, represents that all the information is complete and accurate.

Name:
Date:

Apply Now For A Business Cash Advance

Business Information

Ownership

Bank Information

Landlord

Trade Suppliers

Business Profile

Digital Signature