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Country
Legal Entity
Is Business For Sale?
Is This A Home-Based Business?
Are You Current On Your Rent Or Mortgage Payments?

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What's the situation with your office?

Do You Rent Or Own Your Office Space?

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Business owner information.

Skip here if there is only 1 owner.

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Your funding details.

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Background information. If yes, please explain.

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Supporting documents required.

Last 6 Months of Your Business Bank Account

(All Pages)

Please Submit All Bank Documents in PDF Format Only

If you're submitting supporting documents via email, please make sure they are received within 24 hours for approval.

Email All Above Items To: submissions@expresscapitalcorp.com

The information supplied in this confidential financing application, company profile form, and all forms and documents submitted (collectively the "Application") to Express Capital Corp, LLC, its subsidiaries or its Assignee (collectively "Factor") in connection herewith is true and correct to the best of my/our knowledge. I/we authorize Express Capital Corp, LLC and its Factors to Obtain and Receive my/our business and personal credit through its various agencies for the purpose of evaluation and verification. If this application is printed and faxed, hand signatures are required. But if this form is submitted securely, our typed name(s) and digital signature(s) in the field provided serve as original signature(s).

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