BUSINESS INFORMATION

    CorporationGeneral PartnershipLLCLPSole ProprietorshipLLPS CorporationNonprofit

    MERCHANT/OWNER INFORMATION (1)

    OWNER INFORMATION (2) – ONLY IF MERCHANT/OWNER (1) IS LESS THAN 51% (both Owners must exceed 51%)

    SALES & CREDIT CARD PROCESSING INFORMATION

    Visa/MasterCard:

    YesNo

    JanFebMarAprMayJunJulAugSepOctNovDec

    BACKGROUND INFORMATION

    YesNo

    YesNo

    YesNo

    YesNo

    BUSINESS PROPERTY INFORMATION
    Own/Lease Lease Start Date Lease

    1. Application must include a copy of a voided check, each owner’s valid driver’s license, and your valid business license.

    2. REMITTANCE CAPITAL MANAGEMENT will conduct independent due diligence of each Merchant that desires financing from REMITTANCE CAPITAL MANAGEMENT, and REMITTANCE CAPITAL MANAGEMENT
    may deny financing to any applicant at its sole discretion.

    3. Merchant acknowledges and agrees that a consumer or investigative report, including a credit check with recognized credit reporting agency(s), may be conducted in connection with this Application. Merchant
    hereby authorizes REMITTANCE CAPITAL MANAGEMENT and its agents and representatives to (i) initiate such reports, investigations and/or credit checks, (ii) investigate any statements made or data received from or
    about Merchant and/or its owners/share holders, and (iii) contact any references given by Merchant or its owners/shareholders.

    4. Application must include your last 3 complete, consecutive credit card statements, and 3 months bank statements.

    5. All information must be completed.