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Funding Application
The LCF Group Pre-Qualification Application
First Name
Last Name
Phone Number
Email Address
Business Name
What is Your Monthly Revenue?
$0 - $4,999
$5,000 - $9,999
$10,000 - $24,999
$25,000 - $49,999
$50,000 - $99,999
$100,000 - $249,999
$250,000 - $499,999
Over $500,000
Do You Have A
Business
Bank Account?
Yes
No
Desired Funding Amount
$0 - $4,999
$5,000 - $9,999
$10,000 - $24,999
$25,000 - $49,999
$50,000 - $99,999
$100,000 - $249,999
$250,000 - $499,999
Over $500,000
Get Qualified
The LCF Group Funding Application
Business Legal Name
Business DBA Name
Legal Entity Proprietor
Yes
No
Business Start Date
State of Incorporation
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Federal Tax ID # (EIN)
Physical Address
City
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code
Business Phone Number
Mobile Number
Email Address
Website URL
Type of Business
Agriculture
Attorney
Automotive Repair
Bakeries
Bar/Lounge
Barber Shops
Beauty Shops/Beauticians
Bicycle Shops
Bridal Wear
Candy Stores
Car Dealerships
Catering Halls
Children's Clothing
Chiropractors
Cleaning Services
Communications
Construction
Consultant
Cosmetics/Perfumes
Dairy Products
Dentist
Doctor's Office
Dry Cleaning/Laundry Services
E-Commerce Business
Electrical Services
Entertainment/Recreation
Eye Doctors
Finance
Florist
Food Trucks
Food/Fruit/Gourmet
Footwear
Furniture Stores
Hair/Nail/Skin Care
Hardware
Health Care
Health Spas
Hotel/Motel
Housing Related Business
HVAC Installation/Repair
Insurance Agency
Jewelry Store
Landscaping
Limousine/Transportation
Liquor Stores
Meat/Seafood Stores
Medical Billing
Medical Insurance
Men's & Women's Shoes
Moving Companies
Nightclubs/Lounges
Online Business
Optical Center/Glasses
Party Supplies
Pet Merchandisers
Pet Stores
Pet Walking Services
Pharmacies
Plumbing Services
Restaurants
Retail
Schools and Education
Shipping Companies
Specialty Department Store
Sporting Goods
Sports Memorabilia
Supermarkets/Grocery
Toy/Hobby Stores
Trucking Services
Veterinarians
Wireless/Cellular Stores
Other
Property Ownership
Lease
Own
Rent/Mortgage Payment
Purpose of Working Capital?
Do you have a current advance or loan?
Yes
No
If yes, what is the balance?
Held With:
Original Advance Amount
Payback Amount
Holdback %
Current Credit Card Processor
Average Monthly Credit Card Volume
Gross Annual Sales
Owner Name
Title
Ownership %
Home Phone
Date of Birth
Social Security Number
Home Address
City
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code
The Merchant and Owner(s)/Officer(s) identified above (individually, and "Applicant") each represents, acknowledges and agrees that (1) all the information and documents provided to The LCF Group ("Representative") including credit card processor statements are true, accurate and complete, (2) Applicant will immediately notify Representative of any change in such information or financial condition, (3) Applicant authorizes Representative to disclose all information and documents that Representative may obtain including credit reports to the other persons or entities (collectively, "Assignees") 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"), and each Assignee is authorized to use such information and documents, and share such information and documents with other Assignees, in connection with potential Transactions, (4) Representative and each Assignee will rely upon the accuracy and completeness of such information and documents, (5) Representative, Assignees, and each of their representatives, successors, assigns and designees (collectively, "Recipients") are authorized to request and receive and investigative reports, credit reports, statements from creditors or financial institutions, verification information, or any other information that a Recipient deems necessary, (6) Applicant waives and releases and claims against Recipients and any other information-providers arising from any act or omission relating to the requesting, receiving, or release of information, and (7) each Owner/Officer represents that he or she is authorized to sign this form on behalf of Merchant. A copy of this authorization may be accepted as an original.
I agree to the
Terms of Service
and
Privacy Policy
.
Signature
Signed Date
Submit
(888)499-2939
[email protected]
Business Financing
Merchant Cash Advance (MCA)
Small Business Loans
Invoice Factoring
Line of Credit
Partner
Resources
Industries
Auto Repair Shop Business Loans
Cannabis Business Loans
Construction Business Loans
Home Based Business Loans
Liquor Store Business Loans
Medical Practice Business Loans
Restaurant Business Loans
Retail Business Loans
Trucking Business Loans
Financial Wellness Tracker
Financial Calculators
Working Capital Needs Calculator
Blog
FAQ
Small Business Finance Dictionary
About Us
About Us
Testimonials
Careers
Contact Us
Make a Payment
Apply Now