Business Funding Application – New York City Funding Group

Thank you for your submission!

Business Information

Business Name*

Business Start Date*

EIN*

Incorp State*

Entity Type*

Industry*

Business Address*

Business City*

Business State*

Business Zip*

Gross Annual Sales*

Work Phone*

Owner Information

Title

First Name*

Last Name*

Date of Birth*

Address*

City*

State*

Zip*

Home Phone*

Cell*

Email*

SSN*

Drivers License Number

Drivers License State

Ownership %*

Has Co-Owner*

Co-Owner Information

Title

First Name*

Last Name*

Date of Birth*

Address*

City*

State*

Zip*

Home Phone*

Cell*

Email*

SSN*

Drivers License Number

Drivers License State

Ownership %*

Upload last four months of bank statements*

If past the 15th of the month include month to day transactions here

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Upload copy of license and voided checks

{{ transaction.name }} X

Consent

Owner Signature*

Date*

Co-Owner Signature*

Date*

Please correct the following errors:

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