E-Sign for PPP Loan


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p: (855) 784-0008

e: support@fundible.com

Working Capital Application
Business Information
Business Legal Name: Doing Business As:
State of Incorporation: Federal Tax Identification Number (EIN):
Legal Entity: Business Start Date:
Industry Type:  
Business Financial Information
Annual Business Revenue: Average Daily Bank Balance:
Amount Requested: Use of funds:
Do you have any outstanding loans?: Lender:
Balance: Average monthly payroll:
No. of W2 employees: Did you already receive a first round of PPP? :
Business Address & Information
Business Address: City:
State: ZIP:
Do you own the business property?: Monthly Rent / Mortgage:
Current: Landlord Name:
Landlord Phone:
Primary Owner Information Secondary Owner Information
First Name: Last Name: First Name: Last Name:
Mobile Phone Number: Mobile Phone Number:
Email Address: Email Address:
Home Address: Home Address:
City: State: Zip: City: State: Zip:
Social Security Number (SSN): Social Security Number (SSN):
Ownership %: Est FICO: Ownership %: Est FICO:
Date of Birth: Date of Birth:
It’s okay for my loan specialist to send me text messages.
By signing below, each of the above listed business and business owners/officers (individually and collectively, “you”) certify that all information and documents submitted in connection with this application are true, correct and complete and may be relied upon by Streamline Funding LLC d/b/a Fundible (“Fundible”) and each of its representatives, successors, assigns, designees and third-party funding partners, which includes lenders and other finance providers with whom Fundible has, or may in the future enter into, commercial-brokerage-financing relationships (“Recipients”). You acknowledge that additional information may be required in order to review the foregoing application, therefore you authorize each and every Recipient: (1) to obtain consumer or personal, business and investigative reports and other information about you, including hard and/or soft credit pulls, from one or more consumer reporting agencies, such as TransUnion, Experian and Equifax; (2) to obtain credit card processor statements and bank statements from banks, creditors and other third parties; (3) to obtain the release, by any creditor or financial institution, of any information relating to you, to any Recipients; (4) to transmit this application form, along with any of the foregoing information obtained in connection with this application, to any or all Recipients for the foregoing purposes; and (5) to contact you via e-mail, call and/or text-message at the e-mail address and/or phone number provided above, or at any e-mail address and/or phone number reasonably identified as belonging to you, including wireless numbers (if applicable), even if listed on a Do-Not-Call registry, using an automated telephone dialing system or other similar system with respect to this application, future-related commercial-financing opportunities and/or other lawful telemarketing purposes. You further certify that should any of the foregoing information change, to the extent within your knowledge, that you will promptly notify Fundible of such changes.

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Signature Certificate
Document name: E-Sign for PPP Loan
lock iconUnique Document ID: 4f45e0bb5a599627c9bc5dcb08ba22aa40e21da0
Timestamp Audit
January 13, 2021 12:57 am ESTE-Sign for PPP Loan Uploaded by Dov Kauderer - support@fundible.com IP 103.181.227.136