Broker Company Name *

Broker Email Address *

Broker Points (1 to 15) *

Broker Phone Number *

Submit Commercial Applications - $75k to $150k

Business Information

Full Legal Business Name *

DBA (if applicable)

Company Email Address *

Company Type *

Federal Tax ID / E.I.N. (No Dashes) 🛈

Industry *

Business Phone *

Business Fax

Business Address *

Business Address Line 2

Business City *

Business State/Province *

Business Zip Code *

Business Country *

Is Mailing Address different than above? *

Is this a home based business? *

Mailing Address *

Mailing Address Line 2

Mailing City *

Mailing State/Province *

Mailing Zip Code *

Mailing Country *

State of Incorporation *

Date Established (MM/DD/YYYY) * +

Number of Employees *

Tell us about the Business and Financing Request *

0/10000 characters

Signer Information

First Name *

Last Name *

Company Title *

Ownership % *

Rent/Own? *

Signer/Guarantor Address *

Signer/Guarantor City *

Signer/Guarantor State/Province *

Signer/Guarantor Zip *

Signer/Guarantor Country *

How long at current address? (years)

Email Address *

Mobile Number *

Social Security Number (No dashes) *

Date of Birth (MM/DD/YYYY) +

Is there another Signer or Guarantor? *

First Name (2) *

Last Name (2) *

Company Title (2) *

Ownership % (2) *

Rent/Own? (2) *

Signer/Guarantor Address (2) *

Signer/Guarantor City (2) *

Signer/Guarantor State/Province (2) *

Signer/Guarantor Zip (2) *

Signer/Guarantor Country (2) *

How long at current address? (years) (2)

Email Address (2) *

Mobile Number (2) *

Social Security Number (No dashes) (2) *

Date of Birth (MM/DD/YYYY) (2) +

Equipment Information

Equipment Description *

Equipment Cost *

Term (in months) *

Vendor / Supplier of Equipment

How will this additional equipment/vehicle be used? *

Replace existing piece(s)

Expansion Piece(s)

Location of Equipment After Purchase

Equipment Address *

Equipment Address 2

Equipment City *

Equipment State/Province *

Equipment Zip Code *

Equipment Country *

Financial History

How much revenue did your business do last year (best guess)?* *

Have you ever filed for Bankruptcy? *

Yes - Business Bankruptcy

Yes - Personal Bankruptcy

No

When was the bankruptcy filed ? (mm/dd/yyyy) * +

Upload Attachments

For expedited decisions, please upload the documentation below:

Application *

Personal Credit Report

3 Months' Bank Statements *

3 Months' Bank Statements

Vendor Invoice

Recent Tax Return (Personal) *

Recent Tax Return (Business) *

Interim Financials (P&L / Balance Sheet) *

Personal Financial Statement

Debt Schedule / Facilities List

Additional Documentation

Acceptance

Acceptance *

I accept the following terms outlined below.

By checking the acceptance box, individual(s) who is either a principal (or authorized agent) of the credit applicant listed above or a guarantor of its obligations, provides instruction to TEAM Funding Solutions or its designee (and any nominee or potential assignee thereof) authorizing review of his/her personal consumer credit report from a consumer credit reporting agency. Such authorization shall extend to obtaining a consumer credit report in considering the application of the credit applicant and subsequently for the purpose of conducting background checks, updating, renewing or the extension of such credit and for reviewing and/or collecting the resulting account, now and from time to time, as may be needed in the credit evaluation and review process and waives any right or claim they would otherwise have under the Fair Credit Reporting Act in the absence of this continuing consent. In addition to authorizing review of my/our consumer credit report from any consumer credit reporting agency, the undersigned also authorizes my/our financial institutions and creditors to release credit information required by TEAM Funding Solutions or its designee (and any assignee or potential assignee thereof). BY checking the acceptance box above, I/we affirm our identity as the respective individuals identified in the related application. The undersigned states that all of the statements and information in the application provided are true and complete.