Merchant Application

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Business Information

Please provide key details about your business, including its name, structure, industry, and contact information. This helps us better understand your company's identity and operations.

Business Legal Name *

Do you have a DBA name? *

Business DBA Name *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Business Phone # *

Business EIN *

Do not include dashes or spaces.

Nature of Business *

What type of business? *

Corp
Sole Prop
LLC
Partnership

Years Employed *

1-5
6-10
11-20
30+

Date Started *

Business Reference

Website

Owner/Principal Information

Please provide the personal and professional details of the business owner(s) or principal(s). This information is essential for verifying identity and assessing management background.

Legal Name *

First

Last

Phone *

Email *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Date of Birth *

SSN *

Do not include dashes or spaces.

Driver's License # *

% Ownership of Business *

If less than 100, second owner information will be required.

Estimated Credit Score

Additional Owner Information

Please provide information for the additional owner/principal below.

Legal Name (Owner 2) *

First

Last

Phone (Owner 2) *

Email (Owner 2) *

Address (Owner 2) *

Address Line 1

Address Line 2

City

State

Zip Code

Date of Birth (Owner 2) *

SSN (Owner 2) *

Do not include dashes or spaces.

Driver's License # (Owner 2) *

% Ownership of Business (Owner 2) *

Estimated Credit Score (Owner 2)

Business Financial Information

Please provide accurate and up-to-date financial details about your business. This information will help us assess your company's financial health and support your application process.

Monthly Income *

>5K
$10K-$50K
$100K-$250K
$300K-$500K
$750K-$1M+

Annual Income *

>50K
$100K-$300K
$500K-$1M
$1M-$5M
$5M+
$10M+

Net Worth *

>50K
$100K-$300K
$500K-$1M
$1M-$5M
$5M+
$10M+

Liquidity *

>50K
$100K-$300K
$500K-$1M
$1M-$5M
$5M+
$10M+

Revenue Based Financing Information

Provide key financial details related to your revenue based financing profile, including current funding needs and prior usage. This helps us evaluate suitable options for your business.

What is your monthly credit card volume? *

What is your average bank balance? *

What is the funding amount requested? *

What will be the use of funds? *

If you have other RBF's please specify:

What are your current RBF balances? (Total) *

Document Submission

Please indicate whether or not you will be providing documentation to assist in the application process.

Will you be submitting documentation now?

Bank Statements (4 Months)

Drag & Drop Files, Choose Files to Upload You can upload up to 4 files.

Please upload your last 4 months of bank statements here.

Driver's License

Drag & Drop Files, Choose Files to Upload You can upload up to 2 files.

Please upload a copy of your driver's license here.

Voided Check

Drag & Drop Files, Choose Files to Upload You can upload up to 2 files.

Please upload a copy of an associated voided check here.

Legal Document Disclosure

Review the legal information disclosures pertaining to this application. By proceeding, you acknowledge and accept the terms outlined, including the types of business documentation that may be requested or required for verification.

Print Full Name *

Today's Date *

Signature *

Clear Signature

Print Full Name (Owner 2) *

Today's Date (Owner 2) *

Full Additional Phone

Signature (Owner 2) *

Clear Signature

Confirmation *

I confirm that all information provided is accurate and authorize Pack Funding LLC to verify this information, including obtaining credit and background reports.

By checking the box above the merchant and its owners/principals:

1. GUARANTEE that all information and documents submitted in connection with this application are TRUTHFUL, PRECISE, AND VALID.
2. AUTHORIZE PACK FUNDING LLC to obtain credit reports and other information regarding the merchant, owners, and its principals from third parties to validate any information provided on this application at any given time.

GET FUNDED WITH US

Business Information

Owner/Principal Information

Additional Owner Information

Business Financial Information

Revenue Based Financing Information

Document Submission

Legal Document Disclosure