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in partnership with	p: 646-837-5522 e: funding@upwisecapital.com
Equipment Financing Application

Basic Information
Select Your Industry:	Equipment Type:
Type of Business Entity:	Business Legal Name:
DBA Name:	State of Incorporation:
First Name:	Last Name:

Business Information
Website:	Federal Tax ID:
Gross Annual Revenue:	Average Daily Bank Balance:
Business Start Date:	Monthly Deposit Volume:
Business Address
Business Street Address:	City:
State:	Zip Code:
Business Other Information
Any outstanding loans?:	Second Outstanding Loan:
Lender Name:	Lender Name:
Current Balance:	Current Balance:
Original Funding Amount:	Original Funding Amount:
Payback Amount:	Payback Amount:
Term in Months:	Term in Months:
Primary Owner Information	Secondary Owner Information
Primary Owner's Name:	Secondary Owner's Name:
Date of Birth:	Date of Birth:
Social Security Number:	Social Security Number:
% Ownership:	% Ownership:
Approximate Credit Score:	Approximate Credit Score:
Street Address:	Street Address:
City:	City:
State:	State:
Zip Code:	Zip Code:
I agree to the privacy policy, terms and conditions, terms of application, credit gathering authorization, electronic disclosure and consent, and consent to telephonic communications agreements of this website. .
By signing below, each of the above listed business and business owners/officers/members (individually and collectively, the “Applicant”) certifies that Applicant is authorized to submit this application on behalf of the above-named business. Applicant certifies that all information and documents submitted in connection with this Application are true, correct and complete and may be relied upon by Upwise Capital LLC (“UC”). Applicant authorizes UC to share this application and all supporting documentation with each of its representatives, successors, assignees, affiliates and designees including third party lenders (collectively “Assignees”). that may be involved with the acquiring of commercial loans and/or other products. Applicant further authorizes UC and all Assignees to request, receive, and review any investigative or credit reports, including comprehensive business and personal credit histories or hard credit pulls, and any other information regarding the Applicant and its owners and/or principals from third parties deemed necessary by UC or Assignees to verify any information provided on the Application including without limitation 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. UC shall not disclose information in your credit report to third parties. Applicant also consents to the release, by any credit or financial institution, of any information relating to Applicant, to UC and to each of the Assignees, on its own behalf. Applicant also consents to email and/or text/SMS/fax messages at the phone number(s) provided above, including your wireless number, using an automated telephone dialing system or other similar system for marketing purposes by UC and/or third party lenders, as well as their respective affiliates or agents acting on their behalf. Applicant may Opt-Out anytime by replying STOP. Furthermore, Applicant hereby waives and releases any claims against UC, all Assignees, and any information-providers arising from any act or omission relating to the requesting, receiving or release of the information obtained in connection with this application.

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