Same Day Business Funding Made Easy

First Name *

Last Name *

Email Address *

Business Phone Number *

Business Legal Name *

Business DBA Name

Business Type *

Business Start Date *

Federal Tax ID # (EIN) *

Business Address *

Business City *

Business State *

Business Zip Code *

Mobile Number *

Website URL

Industry

Owner Name *

Ownership % *

Date of Birth *

Social Security Number *

Home Address *

Home City *

Home State *

Home Zip Code *

Do you own multiple businesses? *

YesNo

The Merchant and Owner(s)/Officer(s) identified above (individually, and "Applicant") each represents, acknowledges and agrees that (1) all the information and documents provided to iCapital Funding ("Representative") including credit card processor statements are true, accurate and complete, (2) Applicant will immediately notify Representative of any change in such information or financial condition, (3) Applicant authorizes Representative to disclose all information and documents that Representative may obtain including credit reports to the other persons or entities (collectively, "Assignees") 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"), and each Assignee is authorized to use such information and documents, and share such information and documents with other Assignees, in connection with potential Transactions, (4) Representative and each Assignee will rely upon the accuracy and completeness of such information and documents, (5) Representative, Assignees, and each of their representatives, successors, assigns and designees (collectively, "Recipients") are authorized to request and receive any investigative reports, credit reports, statements from creditors or financial institutions, verification information, or any other information that a Recipient deems necessary, (6) Applicant waives and releases any claims against Recipients and any other information-providers arising from any act or omission relating to the requesting, receiving, or release of information, and (7) each Owner/Officer represents that he or she is authorized to sign this form on behalf of Merchant. A copy of this authorization may be accepted as an original.

I swear or affirm that I am the party described above and that all statements in this application, including those pertaining to my identity are true.

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Signature *

Signed Date *

While one-day or same-day business funding is possible for some merchants, it may not represent the experience of every business. The availability and speed of funding depends on various factors. Individual results may vary.