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Application

Business Information

INDUSTRY TYPE
What type of property?
Seasonal Business?
Current Cash Advance?
COMPANY STRUCTURE
Is your business for sale?

Owner #1 Information

Owner #2 Information

Landlord Information

Trade References

Authorizations

By signing below, each of the above listed business and business owner/officer (individually and collectively, "you") authorize Eminence Funding and each of it's representatives, successors, assigns and designees ("Recipients") that may be involved with or acquire commercial loans having daily repayment features or purchased of futures receivables including Merchant Cash Advance transactions, including without limitation the application therefore (collectively, "Transactions") to obtain consumer or personal, business and investigative reporting agencies, such as TransUnion, Experian and Equifax, and from other credit bureaus, banks, creditors, and other third parties. You also authorize Eminence Funding to transmit this application form, along with any of the foregoing information obtained in connection with this applications, to any or all of the Recipients for the foregoing purposes. You also consent to the release, by any creditor or financial institution, of any information relating to any of you, to Eminence Funding and to each of the Recipients, on its own behalf.