Business Capital Application

Start with a clean business profile.

Initial business funding application. Sensitive identity fields such as full Social Security numbers and driver-license numbers are intentionally not collected through this email-based web form.

Business profile

Legal Business Name

DBA

Date Business Started

Federal Tax ID (EIN)

State of Formation

Legal Structure

Business Address

City

State

ZIP

Business Phone

Website

Full-Time Employees

Part-Time Employees

Revenue & request

Estimated Monthly Revenue

Requested Capital

Intended Use of Funds

Existing MCA / Advance?

Approx. Existing Balance

Business Location

Monthly Rent

Primary owner

Owner Name

Ownership %

Home Address

City

State

ZIP

Mobile Phone

Full SSN and driver-license information are not collected here. If a provider requires additional identity verification, BCF will request it through an appropriate secure process.

Supporting documents

Attach up to five supporting documents, such as recent business bank statements or other relevant business documents. PDF, JPG and PNG accepted. Maximum 10 MB each.

Supporting Document 1

Supporting Document 2

Supporting Document 3

Supporting Document 4

Supporting Document 5

Certification

By submitting, you certify that the information is accurate to the best of your knowledge and authorize Business Capital Firm to use the information for evaluating and brokering potential commercial financing options with third-party providers. Submission is not an approval or offer.

Digital Signature (type full name)

Title

Date

I agree to the certification, privacy policy and brokerage disclosure.