Bank Loan form Business Loan App UBI License: 605349086 Please fill out this form for our sales team to contact you shortly. Please sign the DocuSign form docs Check Email Required Docs Image Driver's license Last three bank statements EIN Confirmation Letter from IRS Business Bank letter or Voided Check Business Officer InformationPlease include your personal business officer informationFirst NameLast NameDate of BirthSocial Security # or ITINDriver's License UploadChoose File Personal PhoneDriver's License#Business InformationPlease provide your business detailsEIN Letter UploadChoose File Business NameDo you own or rent location? Own RentExisting Business loan/advance? Yes NoMonthly Rent - BusinessLandlord nameLandlord Phone numberFederal tax id (EIN)Please select OwnershipOwnerPresidentManagerOtherPercentage Ownership Business50%100%Business DBA - If no DBA Leave BlankYears in business or monthsBusiness AddressBusiness PhoneBusiness EmailBusiness websiteBusiness Industry- Select -RetailRestaurantFast foodSalonHospitalityFashionPet StorePet shopMedicalBarbershopProfessional ServicesSupermarketBakerySupermarketMeat MarketOnline StoreOtherBank DetailsBank informationBank NameBank Routing NumberBank Account NumberVoided Check UploadChoose File Bank Statement 1Choose File Bank Statement 2Choose File Bank Statement 3Choose File Business taxesChoose File By signing this application, each of the above listed businesses and business owner/officer (individually and collectively, "you") authorize (Telutron, LLC) and each of its representatives, successors, assigns and designees ("Recipients") that may be involved with or acquire commercial business loans having daily/weekly 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 (Telutron, LLC) to transmit this Application, with any of the foregoing information submitted/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 (Telutron, LLC) and to each of the Recipients, on its own behalf. You intend to sign this Application electronically and consent to transacting business with (Telutron, LLC) and its affiliates electronically. You are providing your business cell phone and business e-mail address and hereby consent to the receipt of correspondence/messages regarding transactions with (Telutron, LLC) and/or its affiliates on either medium. You also hereby consent to the receipt of text messages knowing that msg and data rates may apply (approximately 10 msgs/month). You understand that consent to conduct business via electronic signatures and to receive text messages are not a condition of approval and you may opt-out of either/both by contacting (Telutron, LLC) at sales@telutron.com. Your signature above certifies that you are authorized to sign this application on behalf of the Business and all the information contained herein is complete, true and accurate. YesSelect DateConfirm your name to AuthorizeSubmit Request
