Application for Signature loan | Small Business Loan           

Full Name:            

Company Name:    

Describe Business: 

Telephone:            

City |State:            

Broker or Principal?: Principal Broker Attorney                             

Email Address:       

Loan Amount:        

What is your time frame for Funding:   

Declined at other lenders?                   

Best Time to Contact                          

REQUEST DETAILS

Type of Financing Requested:

Signature Business Loan Merchant Cash Advance Unsecured Line of Credit

Time in Business:                                              

Lease or Own building:                                      

Number Business Owners:                                 

Annual Sales Volume:                                       

Is business Seasonal:                                        

MERCHANT INFORMATION

Monthly Credit Card Volume:                             

Number of Swipes Per month:                           

Last 3 Months Merchant Volume Average:           

Merchant Processor Name:                                

Number of Credit Card Terminals at location?      

Can you provide Business Merchant Statements?  

BANKING INFORMATION

Number of Bank Deposits Monthly:                      

Average Monthly Bank Balance ?                         

Number of Overdrafts Monthly:                           

Can you provide Business Checking Statements?   

CREDIT INFORMATION

FICO SCORE:                                                   

Any BK's? If Yes Date:                                       

Any Existing Loans or Merchant Advances?          

If Yes to above List all Loans, Advances, etc:                             

Additional Information (use of funds) to better explain your request:

The above information is true and correct. I authorize Omega Funding, Inc to contact me about the above request.