Step 1 of 4 — Contact Information
Business Funding Application
1
Contact
2
Business
3
Documents
4
Signature
Contact Information
First Name
*
Last Name
*
Date of Birth
*
Social Security Number
*
Email Address
*
Mobile Phone
*
Business Name
*
Consent to Communications:
By providing your contact information and signing below, you authorize Premium Merchant Funding (PMF) and its representatives, successors, assigns, and designees to communicate with you via phone calls, text messages, and emails, including automated technology and pre-recorded messages, for informational, marketing, or transactional purposes. Standard message and data rates may apply. Message frequency may vary. You may opt-out at any time by replying "STOP" to text messages, unsubscribing from emails, or contacting us directly. For help, reply "HELP" at any time or contact us at
support@pmfus.com
. You further authorize PMF and its designees to obtain consumer, personal, business, and investigative reports about you from consumer reporting agencies (including TransUnion, Experian, Equifax, and Identity IQ), banks, creditors, government agencies, and other third parties (collectively, the "Recipients"). PMF may transmit this application form, along with any information obtained in connection with it, to any or all Recipients for purposes related to commercial loans or purchases of future receivables (collectively, "Transactions"). You also consent to the release, by any creditor or financial institution, of any information relating to you, to PMF and each of the Recipients. PMF is authorized to communicate with the Recipients on your behalf and represent you in matters related to the Transactions. Your information will be handled in accordance with our
Terms of Use and Privacy Policy
.
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Business Details
Business Start Date
*
Industry
State of Incorporation
*
Tax ID / Company Number
*
Entity Type
*
Business Phone
*
Company Website
This business does not have a website
FICO Score
*
Ownership %
*
100% ownership — no partner required
Ownership < 100% — partner info required
Number of Employees
*
Amount Requested
*
Do you process credit cards?
Do you own multiples businesses?
Is your business home based?
Home/Business Address
Address Line 1
*
Address Line 2
City
*
State
*
Zip
*
I own home property
*
Home Property Value ($)
*
Home Property Equity ($)
*
Partner Information
Partial ownership detected — partner details required
Partner Ownership %
*
Partner FICO Score
*
Partner First Name
*
Partner Last Name
*
Partner Date of Birth
*
Partner SSN / NIN
*
Partner Business Email
Partner Mobile Phone
*
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Document Upload
Upload the required documents to complete your application.
Bank Statement(s)
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Additional Document(s)
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browse
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Consent & Signature
Consent to Communications
By providing your contact information and signing below, you authorize Premium Merchant Funding (PMF) and its representatives, successors, assigns, and designees to communicate with you regarding your application and any related transactions, including via phone calls, text messages, and emails. These communications may include automated technology and pre-recorded messages. Standard message and data rates may apply. You may opt-out at any time by replying "STOP" to text messages, unsubscribing from emails, or contacting us directly.
Marketing Communications
Separately, you may choose to receive marketing messages (including special offers, product updates, and promotions) from PMF and its designees. By checking the box below or signing separately, you authorize us to send these marketing communications via phone calls, text messages, and emails, including automated technology and pre-recorded messages. Standard message and data rates may apply. You may opt-out of marketing messages at any time using the same methods described above.
Authorization to Obtain and Share Information
You authorize PMF and its designees to obtain consumer, personal, business, and investigative reports about you from consumer reporting agencies (including TransUnion, Experian, Equifax, and Identity IQ), banks, creditors, government agencies, and other third parties. PMF may transmit this application form, along with any information obtained in connection with it, to any or all Recipients for purposes related to commercial loans or purchases of future receivables.
Applicant Signature
*
Clear Signature
Partner Signature
*
Clear Signature
I certify that all information provided is true and accurate to the best of my knowledge
*
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