AEM Capital Funding Group.com

Application

Direct: 844-707-0079
Legal Business Name (click + to add DBA)*
Business Number*

Area CodePhone Number
Email*
Amount Requested*
Business Address*

Street Address

Street Address Line 2

CityState / Province

Zip Code
Business Structure/Type*

Sole PropCorpLLCPartnerOther
Industry Type*
Monthly Revenue*
Business Start Date*
Tax ID Number*
CC Percentage of deposits?
Existing Loan/Advance Balance*
Liens / Judgments / Claims*
Rent or Own
Ownership Information
Officer/Owner Name*

First NameLast Name
Mobile Number*

Area CodePhone Number
Email*
SSN*
Home Address*

Street Address

Street Address Line 2

CityState / Province

Zip Code
% Ownership *
Estimated FICO Score*
Date of Birth*

MonthDayYear
Date
Second Officer/Owner Name

First NameLast Name
Mobile Number

Area CodePhone Number
Email
SSN
Home Address

Street Address

Street Address Line 2

CityState / Province

Zip Code
% Ownership
Estimated FICO Score
Date of Birth

MonthDayYear
Date
Collateral*
What type of collateral?
Total Estimated Value:
Total Estimate Debt Amount:
Terms & Conditions: The Merchant and Business Owner(s) identified on this application (individually, the "Applicant") each represents, acknowledges, and agree that (1) all information and documents provided to AEM Capital Funding Group (AEM), represent a true, accurate and complete description of business and applicant. (2) By submitting this application Applicant authorizes AEM and/or its funding partners to request, obtain and receive any investigative reports, credit reports, statements of creditors or financial institutions, verification of information, or other information deemed necessary to evaluate Applicant. (3) Applicant waives and releases AEM from any claims arising from the release of and/or the receipt of information relating to the applicant's request for business financing. (4) Owner/Applicant represents that he or she is authorized to sign this form on behalf of the business and agrees to receive all forms of communication (calls, email text, other) from AEM and its agents.
Name*

First NameLast Name
Signature*

Clear
Second Owner

First NameLast Name
Signature

Clear
Todays Date*

MonthDayYear
Date
Browse Files

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Should be Empty:

Application

Ownership Information