"*" indicates required fields Step 1 of 2 50% Your Name* First Last Your Email* How Did You Hear About Us?ColleagueReferral Partner CalledAdvertisementGoogleEmail OfferOther BUSINESS INFORMATIONLegal/Corporate Name* DBA* Tax ID/EIN* Entity Type*Sole ProprietorshipCorporationLLCOtherType Of Business* Product/Service Offered* Length Of Ownership* Date Of Incorporation* Month Day Year Phone Number*Email Address* Street Address* City* State* Zip Code* Do you currently have a cash advance?*NoYesIf Yes, With Which Lender?* Balance Of Cash Advance* BUSINESS OWNER INFORMATIONName* First Last Social Security Number* Date Of Birth* MM slash DD slash YYYY Owner %* Street Address* City* State* Zip Code* Home Phone*Cell Phone*Is there a business partner?*NoYesCredit Score500-550550-600600-650650-700700-750750-800800-850BUSINESS PARTNER INFORMATIONName* First Last Social Security Number* Date Of Birth* MM slash DD slash YYYY Owner %* Street Address* City* State* Zip Code* Home PhoneCell PhoneEmail Credit Score500-550550-600600-650650-700700-750750-800800-850TermsBy signing below, each of the above-listed business and business owner/officer (individually and collectively, “you”) authorize Perlman Syndications DBA Black Tie Funding (BTF) and each of its representatives, successors, assigns, and designees (“Recipients”) that may be involved with or acquire commercial loans having daily repayment features or purchases of future receivables including Merchant Cash Advance transactions, including without limitation the application therefor (collectively, “Transactions”) to obtain a consumer or personal, business and investigative reports and other information about you, including credit card processor statements and bank statements, from one or more consumer reporting agencies, such as TransUnion, Experian, and Equifax, and from other credit bureaus, banks, creditors and other third parties. You also authorize BTF to transmit this application form, along with any of the foregoing information obtained in connection with this application, to any or all of the Recipients for the foregoing purposes. You also consent to the release, by any creditor or financial institution, of any information relating to any of you, to BTF, and to each of the Recipients, on its own behalf. You consent to receive e-mail, text messages, facsimiles, and telephone calls from BTF, its employees, and agents to the numbers you have provided. You consent to receive these communications regardless of whether your telephone numbers appear on state or federal Do Not Call lists, and this consent for messaging does not bind you to any term of your application or advance. Std. cellular rates will apply.Signature*Please print your name* Date* SignaturePlease print your name Date Upload Drivers LicenseMax. file size: 128 MB.Upload Void CheckMax. file size: 128 MB.Upload 3 Bank Statements Drop files here or Select files Max. file size: 128 MB, Max. files: 3. CAPTCHAEmailThis field is for validation purposes and should be left unchanged. Δ Join our email list! Success! Email Subscribe
