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Get a Free Business Financing Consultation, With No Obligation
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Step
1
of 3
BUSINESS FUNDING APPLICATION
Legal Name of Merchant (the “Merchant”)
*
Doing Business As (DBA) Name
Merchant Business Address (No PO Boxes)
Time in Business
*
First
Last
Website
City
Province
Postal Code
Business Legal Entity Type
Products or Services Sold
Business Phone
Business Fax
Amount of Funds Requested
Business Property
Rent
Own
Monthly Rent/Mortgage
Are you currently working with a non-bank financing company?
Yes
No
Total Annual Sales
Business Identification Number
If Yes, Company Name
& Current Balance
Next
OWNER DETAIL 1
Full Name
*
First
Last
Date of Birth (mm/dd/yyyy)
*
MM
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Title in Business
Ownership Percentage(%)
Home Address
*
SIN
E-mail Address
*
City
Province
Postal Code
Home Phone Number
Cell Phone Number
Does your company have more than one owner?
*
Yes
No
OWNER DETAIL 2
Full Name
First
Last
Date of Birth (mm/dd/yyyy)
MM
1
2
3
4
5
6
7
8
9
10
11
12
DD
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
YYYY
2027
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Title in Business
Ownership Percentage(%)
Home Address
SIN
E-mail Address
City
Province
Postal Code
Home Phone Number
Cell Phone Number
Next
EMERGENCY CONTACT - ALL FIELDS ARE MANDATORY
Contact Name
Relation
Phone
*
Bank Statement (pdf only)
Drag & Drop Files,
Choose Files to Upload
You can upload up to 10 files.
SIGNATURES – ALL OWNERS MUST SIGN
By signing below, the Merchant and its owner(s) certify that all information and documents submitted in connection with this Application are true, correct and complete . Additionally , the owner(s) authorize 10887382 Canada Inc & 2631641 Ontario Inc. or any of its agents, lenders, partners , and affiliates to contact the above landlord, supplier, and emergency contacts , as well as obtain and use business and non-business consumer credit reports from credit reporting agencies and any other information regarding the Merchant and its owner(s) from third parties, both at the time of the initial funding application and at any time after the Merchant has received funding as long as the Merchant remains a client of the Funder. At all times, the Funder will comply with the personal information collection , protection , use, sharing, and retention practices set out in the Funders Privacy Policy. You authorize us to collect, hold, exchange and disclose your personal information as requested in order to administer Years: _____ Months: _____ City Province Postal Code Date of Birth (mm/dd/yyyy) Title in Business Ownership Percentage SIN Home Phone Number Cell Phone Number Home Address E-mail Address City Province Postal Code funding and determine your insurance eligibility as required or permitted by law. You also authorize us to use your personal information for internal statistical analysis purposes. If you would like to review your own personal information, correct or revise existing information, have any questions, concerns or comments regarding it’s application please call 1 877 386 3664 or email info@servicecapital .ca (Attn: Privacy Office)
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