Universal Business Credit Application

Legal Form of Entity & Authorized Signer (Please Select and Complete as Indicated):

Legal Form of Entity:

Date of Organization:

State of Organization:

Federal Tax ID #:

Number of Partners/Shareholders/Members/Owners in Business: (Please List Them Below)

Merchant Primary Establishment Address (if Different):

City:

State:

Zip:

Phone:

Fax:

Cell Phone:

How Long Have You Owned the Establishment? Years Months

Number of Employees:

Number of Additional Locations Under Same Legal Corporate Entity:

Has the Business or Owners Ever Filed For Bankruptcy?

Yes

When?

Does the business or owners have tax liens?

Yes

Type of lien:

Name of Landlord:

Landlord Phone:

Business Sales Information

Total Annual Credit Card Sales?: $

Total Annual Sales (Cash + CC)?: $

Number of Seats (if applicable):

Cuisine type (if applicable):

Banking Institution for Business Account(s):

Has this bank been open for at Least 90 days?

Yes

Is Your Business Seasonal?

Yes

% Sales Decrease In Low Volume Months: %

List Low Volume Months:

Existing Cash/Financing Providers

Number of Existing Loans/Cash Advances:

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Information on Loan Guarantor (Required)

Name of Guarantor:

Date of Birth:

Social Security Number:

Drivers License #:

State:

Email Address:

Home Address:

City:

State:

Zip:

Home Phone:

Cell Phone:

Do You Own or Rent?

Own

Rent

How Long? Years Months

Have You Declared Personal Bankruptcy in the Past?

Yes

When?

Do You Currently Have Collection Issues Pending?

Yes

I hereby give permission to ARF Financial, LLC ("ARF"), or any agent or credit-reporting agency that it may designate, to obtain any and all information concerning my assets and other credit matters, which they may require in connection with this credit Application. I specifically acknowledge and agree that (1) all statements which I have made in this Application are made for purposes of obtaining the financing, (2) verification and reverification of any information which I have supplied in connection with this Application may be made at any time by ARF, either directly or through a credit reporting agency, from any source named in this Application and the original copy of the Application will be retained by ARF, even if the financing is not approved, (3) ARF will rely on the information which I have supplied herein and I have the continuing obligation to amend and/or supplement that information if any of the material facts which I have represented should change prior to the total obligations under the credit Agreement being paid in full and (4) each Guarantor, upon request from time to time by ARF, will provide ARF with financial statements and such other information as ARF deems appropriate, all in form and detail satisfactory to ARF. This Application is part of a credit review process and additional information may be required. ARF may render a credit decision on this application or may elect to submit this Application to one or more banks on the applicant's behalf and any institution considering this Application shall make its own credit decision regarding this Application. The sales representative submitting this Application cannot extend credit or commit to any financing or funding until a credit decision has been made by the appropriate institution.

Signature of Business Authorized Signer & Loan Guarantor:

Digital Signature Acknowledgment: By providing your digital signature below, you acknowledge and agree that your digital signature is legally binding and has the same legal effect as a handwritten signature. You understand that this digital signature constitutes your original signature and agreement to all terms and conditions contained in this application.

The Company and the undersigned principal owner of the Company identified above ("Applicant") represents, acknowledges, and agrees that (1) all information and documents provided to 1st New York Capital ("Provider") are true, accurate, and complete, (2) Applicant will immediately notify Provider of any change in Applicant's financial condition, (3) Provider is authorized to submit this Application and all supporting documents provided by Applicant to its' affiliates, representatives, successors, assigns, designees, agents, partners, and third-party financial institutions for the purpose of considering commercial financing offers to Applicant (collectively "Recipients"), (4) such Recipients are authorized to request and receive any investigative reports, consumer credit reports, statements from creditors or financial institutions, verifications of information, or any other information that Recipients deem necessary in considering this Application, (5) the undersigned represents that they are authorized to sign this form on behalf of the Company, and (6) THE COMPANY AND PRINCIPAL CONSENT TO RECEIVE CALLS, TEXTS, AND EMAILS FROM PROVIDER AND RECIPIENTS BASED UPON THE CONTACT INFORMATION OF APPLICANT PROVIDED IN THIS APPLICATION.

Please type your full name for digital signature:

Your typed name will serve as your digital signature

Date:

Merchant Authorized Signer's Title:

This application must be completed in its entirety. It must be signed and dated by an Authorized Signer of the Merchant who is also the Loan Guarantor.
Along with this application please fax the Merchant's three most current credit card statements and the most current bank statement. However, if cash sales are materially higher than credit card sales (by at least 25%) then please fax three months of the most current bank statements and the most current credit card statement.
How would you like to be contacted about this financing request?

Business Phone

Cell Phone

Home Phone

E-Mail

Business Fax

Transmittal of this Application and all information to be attached may be made by facsimile transmission.

UNIVERSAL BUSINESS CREDIT APPLICATION

1st New York Capital

Questions or more information: