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You & Pivot Capital Group Funding Your Business...
Your Company's Legal Name ?
*
Doing Business As ? (DBA or DBAs)
Company Legal Address?
Phone Number ?
What is Your Email Address ?
Website Address/URL.... or No Website ?
Date Company was Formed ?
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Month
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Day
Year
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Years Under Current Ownership?
Estimated Gross Revenue Last Year?
Estimated Net Income Last Year?
Years In Current Industry?
State Company was Formed In?
Legal Business Type
C-Corp
S-Corp
LLC
LLP
Partnership
Sole Proprietorship
Non-Profit
Federal Tax ID Number ?
*
Owner/Guarantor 1: Name, Date of Birth, Home Address, Phone, % Ownership, Marital Status, Years in Current Residence, Homeowner or Rent, Monthly Payment for Residence, Social Security Number?
*
Owner/Guarantor 2 (if additional) : Name, Date of Birth, Home Address, Phone, % Ownership, Marital Status, Years in Current Residence, Homeowner or Rent, Monthly Payment for Residence, Social Security Number?
Owner/Guarantor 3 (if additional) :Name, Date of Birth, Home Address, Phone, % Ownership, Marital Status, Years in Current Residence, Homeowner or Rent, Monthly Payment for Residence, Social Security Number?
Please Upload Last Month's Business Bank Statement - ALL PAGES- Click CHOOSE FILE (and select then upload)
Please Upload Month-Before-Last Business Bank Statement - ALL PAGES- Click CHOOSE FILE (and select then upload)
Please Upload 2 Months-Before-Last Business Bank Statement - ALL PAGES- Click CHOOSE FILE (and select then upload)
Please Upload 3 Months-Before-Last Business Bank Statement - ALL PAGES- Click CHOOSE FILE (and select then upload)
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By signing with mouse or finger Your name(s) You are electronically signing, each undersigned individual (s), who is either a principal of the credit applicant listed below or a personal guarantor of its obligations, provides written instruction to Pivot Capital Group or its designee (and any assignee or potential assignee thereof) authorizing to obtain his or her personal credit profile from a national credit bureau. Such authorization shall extend to obtaining a credit profile in considering the application of the credit applicant and subsequently for the purposes of update, renewal or extension of such credit and for reviewing or collecting the resulting account.I authorize all deposit, borrowing, and trade information to be released to the Lessor/Lender. I represent all information is true, correct and complete. A photostatic or facsimile copy of this authorization shall be as valid as the original. TYPE YOUR NAME(S) IN THE SPACE PROVIDED IF YOU AGREE
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Upload Picture of Utility Bill Showing Address
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Upload Picture of Driver's License
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