EJN Financial Business Funding Application

EJN Financial Business Funding Application

Email: esta@ejnfinancial.com

Call : 727-513-6983

Please Fill All Required Fields And Any Additional Fields Pertaining To Your Application

Today's Date *

Entity Type *

Business Name *

Industry

Business Address *

City *

State / Povince *

Postal code *

Business Start Date *

Business Tax ID *

Website

Email *

Business Owner Information

If ownership less than 100% please complete information for other business owners as well**

Ownership %

First Name *

Last Name *

Home Address (Not Business Address or P.O Boxes) *

FICO Score *

Home Phone *

Cell Phone *

Personal Email *

Date of birth *

Social Security Number *

Driver's License State

Driver's License #

Business Owner # 2

To be Filled out by any partner that has 25% or more ownership

Business Owner 2 Ownership %

Business Owner 2 First Name

Business Owner 2 Last Name

Business Owner 2 Address

Business Owner 2 FICO

Business Owner 2 Cell Phone Number

Business Owner 2 Email

Business Owner 2 Date of Birth

Business Owner 2 Social Security Number

Business Owner 2 Driver's License State

Business Location *

Website Remote

Home Based

Storefront

Gross Annual Sales $ *

Visa/MC Sales Per Month $

Credit Card Processor

Has The Business Ever Filed For Bankruptcy? *

Yes

No

Bankruptcy Year Filed

Is The Business Behind On Paying Vendors?

Yes

No

Does The Business Have Tax Liens?

Yes

No

Amount Of Tax Lien

Is There A Payment Plan?

Yes

No

Start Date of Tax Lien

Is This Your Only Business?

Yes

No

Number Of Businesses Owned

Does The Business *

Own

Lease

Time Left On Lease

Monthly Lease/Mortgage Payment

Landlord/Mortgage Company Name

Landlord/Mortgage Company Phone Number

Business Banking Name

Bank Branch City and State

Bank Contact Name

Bank Contact Phone Number

If Yes, Who?

Would You Want to Use Real Estate As Collateral for a Larger Loan?

Yes

No

If Yes, Property Type

Do You Have Existing Cash Advances? *

Yes

No

How Many?

Dealer Name

Dealer Address

Dealer Email

Equipment Description

New Or Used

New

Used

Model

Manufacturer

Year

Equipment Cost $

$

Add any notable information you need us to have not covered on questions above

By signing below, each of the above listed business and business owner/officer (individually and collectively, "you") authorize EJN FINANCIAL. 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 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 EJN FINANCIAL to transmit this application form, 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, EJN FINANCIAL. and to each of the Recipients, on its own behalf

Signature Owner # 1 *

Clear

Signature Owner # 2

Clear

To Help Us Expedite Your Loan Application Please Upload Supporting Documents.

Last 4 Months of Business Bank Statements

Copy Of ID

Copy Of Business Voided Check

If Purchasing Equipment and you have access to it**

Equipment Invoice-Bill Of Sale

You Can Use The Same Upload Button For Multiple Files Multiple Times. Thank You!!!!

Please Upload The Documents Listed Above-You may Submit Your Application and send document later on if needed by clicking Submit below. Thank you!

Upload You Documents Here