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Required Loan Documents
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MERHCANT CASH
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BUSINESS NAME
(Required)
BUSINESS DBA:
STATE OF INCORPORATION:
(Required)
BUSINESS START DATE /MONTH
Tax EIN Number
(Required)
Business Entity Type (pick one):
(Required)
Corp.
LLC
LLP
Part.
Sole Prop.
Other
BUSINESS PHONE NUMBER:
(Required)
CELL PHONE NUMBER:
(Required)
WEB ADDRESS:
BUSINESS EMAIL:
(Required)
TYPE OF INDUSTRY
(Required)
AUTO
BAR
CLEANERS
CLOTHING
DAY CARE
DELICATESSEN
DENTIST
DOCTOR OFFICE
FLORIST
GARDEN CENTER
GROCERY STORE
GYM
HAIR &NAIL SALON
LIQUOR
HOTEL MOTEL
MARTIAL ARTS
NIGHT CLUB
OPTICAL OUTLET
PET STORE
RESTAURANT
TANNING
OTHER
(Industry Type if other) Please describe
BUSINESS STREET ADDRESS:
(Required)
CITY:
STATE:
ZIP CODE:
city:
STATE:
ZIP CODE
BUSINESS CHECKING DEPOSITS MONTHLY:
(Required)
MONTHLY CREDIT CARD SALE VOLUME
FIRST NAME/PRIMARY OWNER/OFFICER
(Required)
LAST NAME
(Required)
SS#
(Required)
DATE OF BIRTH:
(Required)
HOME PHONE:
CELL PHONE NUMBER:
(Required)
HOME ADDRESS:
(Required)
CITY:
STATE:
ZIP CODE
DESIRED LOAN AMOUNT:
(Required)
SELECT YOUR LOAN BROKER:
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BRUCE PIAZZA
MICHAEL PIAZZA
PATRICK SACCOR
JOE THOMAS
ROGER GULLEY
JIM LOOMIS
GLENN JUDEBETH
FRED SHATZOFF
FRAN NEMORIN
TERRY MONDO
JEFFREY HINES
DANIEL STRONG
MARK EBOIGBE
MICHAEL MAIELLA
CARLOS MARINO
MICHAEL SIANI
DANIEL OLSON
TONY ADIMEY
STEVE ELLIOTT
DANIELLA CALA
ROBERT SWABY
ROD HARRIS
JASON ALLEN
TOM KAUPPINEN
DANIEL JOHNSON
Terms and condition
terms and conditions
(Required)
By signing below, each of the above listed business and business owner/officer (individually and collectively, “you” authorize PAYLO CAPITAL and each of its representatives, successors, assigns and designees (“Recipients”) that may be involved with or acquire commercial loans having daily repayment features or purchases of future receivables including Merchant Cash Advance transactions, including without limitation the application therefor (collectively, “Transactions”) to obtain consumer or personal, business and investigative reports and other information about you, including credit card processor statements and bank statements, from one or more consumer reporting agencies, such as TransUnion, Experian and Equifax, and from other credit bureaus, banks, creditors and other third parties. You also authorize PAYLO CAPITAL to transmit this application form, along with any of the foregoing information obtained in connection with this application, 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 PAYLO CAPITAL and to each of the Recipients, on its own behalf
(Required)
Contact me about eliminating my credit processing
Contact me about eliminating my credit processing fees
Required Business Documents- LAST 4 MONTHS BUSINESS BANK STATEMENTS
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Max. file size: 32 MB.
