Application

Business Legal Name *

Type of Entity*
Please SelectCorporationLLCLLPSole Prop

Federal Tax ID # / EIN*

Business Start Date*

Amount Requested*

Annual Revenue*
Please Select$100k to $250k$251k to $500k$501k to $750k$750k to 1.25M$1.25M to $2.5M$2.5 M to $5MOver $5M

Industry Type*

Use of Funds*

Business Address*

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Business #*

Please enter a valid phone number.

Mobile #*

Please enter a valid phone number.

Owner 1 Information

Full Name*

First Name

Last Name

Home Address*

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Date of Birth*

SSN*

Ownership %*

E-mail*

By signing below, the Merchant and its owners / principals: (1) certify that all information and documents submitted in connection with this Application are true, correct and complete; (2) authorize SSSZ llc dba SBS Advance and its agents, partners, and lenders to receive credit reports and any other information regarding the Merchant and its owners and principals from third parties, to verify any information provided on the Application; and (3) to receive an occasional promotion or offer by email or text.*
By Clicking the Submit Button I agree to terms & conditions.

In order to complete the application process, please attach the last 3 months including the current month to date activity of your business bank statements in PDF format. (If you wish to send the bank statements via email or fax please click Will Send seperately and Finish)*
Statements are attachedWill send statements seperately

File Upload*

Signature*

Date*