Nathan Clark
Business Development Officer
(678) 288-9672
 4485 Tench Rd, Suite 220
     Suwanee, GA 30024
 
 
Online Application
Secure Online Application
How did you hear about us?
Business Information
* Required Fields
Company Name*
Business Phone*
Alt Phone*
Business Address*
 
 
 
Amount Requested*
$ .00
Federal I.D. No
Date of incorporation*
Industry Experience*
if a Sole Prop, prior to forming an entity, provide verifiable date*
Type of Incorporation/Ownership*
Type of Business*
Owner 1
* Required Fields
Full Legal Name *
 
 
Title*
Ownership %*
SSN Number*
Phone (Home)
Phone (Cell)
Phone (Alt)
Date of Birth*
Email Address*
* Home Address
 
 
 
Are you a US Citizen?
  Yes
  No
Are you a Permanent Resident?
  Yes
  No
Are you a Homeowner?
  Yes
  No
Owner 2
(If Applicable)
Full Legal Name
 
 
Title
Ownership %
SSN Number
Phone (Home)
Phone (Cell)
Phone (Alt)
Date of Birth
Email Address*
Home Address
 
 
 
Are you a US Citizen?
  Yes
  No
Are you a Permanent Resident?
  Yes
  No
Are you a Homeowner?
  Yes
  No
Financial Needs
* Required Fields
Describe what your financial needs are. Please be specific.*
Terms of Financing
Purchase Price
$ .00
Has Any Owner/Officer filed Bankruptcy in the last 5 Years?*
Do you have collateral that you would like to pledge?
If so, please describe items with estimated value:
Financial Documents
(Optional, but Recommended)

Uploading your financial documents will speed up your loan process. Please upload the following:

  • Most recent business bank statements - 3 months
  • Most recent business and personal tax returns - 2 years
  • Most recent 1099 (if applicable)
  • Current business profit & loss statement and financial statement
  • Credit report

File 1:
File 2:
File 3:
File 4:
File 5:
Electronic Signature (please type full name):*