Verifen

Funding Application

Complete the below secured application to get started.

The application requires 6 months of business and personal bank statements, and your Articles of Incorporation.

  • Business Information
  • Owner Information
  • Loan Details
  • Document Upload
  • Signature

Let's start by getting to know your business.

Company Name
Doing Business As (DBA)
Date of Formation (MM/DD/YYYY)
Entity Type
EIN (Employer Identification Number)
Business Location
Website (Enter url)
Business Phone Number
Business Email Address
Company Legal Address
Street Address
Unit/Suite
City
State
Zip Code
Years in Business
Annual Gross Revenue
Annual Net Revenue
Average Daily Bank Balances
Industry (e.g., Retail, Technology, Manufacturing, etc.)

Tell us about the business owner.

% of Ownership (Enter Amount Number)
Full Name (First Name, Last Name)
Email Addresss
Mobile Number
Phone Number
Social Security
Date of Birth
Owner’s Home Address
Street Address
Unit/Suite
City
State
Zip Code
Annual Personal Income
Cash on Hand (Amount available in personal accounts)
Do you Own or Rent your Home?
Monthly Mortgage or Rent Payment
Credit Score
Have you ever filed for Bankruptcy?
State Issued
Driver License Number
Driver License Expiration Date:
Upload Driver License (2 files upload front and back.)

How much capital are you seeking?

Please enter an amount
Preferred Loan Term
How do you plan to use the funds?
How soon do you need access to these funds?

Please upload the following documents to complete your application:

6 months of Business Bank Statements

Choose an image file or drag it here.

6 months of Personal Bank Statements

Choose an image file or drag it here.

Personal Credit Report
Most Recent Business Tax Return
Most Recent Personal Tax Return

Please type or draw your signature here:

Full Name
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