Asset-Based Lending Application Our simple Asset-Based Lending application will gather information about you, your business, and the business performance. It generally takes between 5 and 10 minutes to complete. There are no fees and no obligations to apply. Of course, any questions, at any time, simply contact us. We are always happy to assist. Really! * All fields are required Unique IDName* First Last Email* Password* Enter Password Confirm Password Between 8–30 characters, and should include both upper and lower case letters, at least one number, and at least one symbol or special character. Phone*How did you hear about us?*-- Select --AffiliateBingEmailGoogleInternet SearchFriendOtherAffiliate Id*Enter the Affiliate’s 6-digit Identification Other*How much funding do you think that you need?*How soon do you need the financing?*-- Select --3 days1 week2 weeks4 weeksmore than 1 monthUse of funds*Business InformationLegal business name*DBA (if different)Business address*Business city*Business state*-- Select --AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaOntarioQuebecPrince Edward IslandSaskatchewanBusiness zip code*Business country*-- Select --USACanadaBusiness phone*Legal Entity Type*-- Select --CorporationGeneral PartnershipLimited Liability CorporationLimited Liability PartnershipNon-ProfitSole ProprietorshipState of Incorporation*-- Select --AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaNew BrunswickBritish ColumbiaManitobaNova ScotiaNewfoundland and LabradorOntarioPrince Edward IslandQuebecSaskatchewanBusiness start date* MM slash DD slash YYYY Business tax ID*Is the business in active bankruptcy?*-- Select --NoYesIndustry*-- Select --Accommodation and Food ServicesAdministrative and Support and Waste Management and Remediation ServicesAgriculture, Forestry, Fishing and HuntingArts, Entertainment, and RecreationConstructionEducational ServicesFinance and InsuranceHealth Care and Social AssistanceInformationManagement of Companies and EnterprisesManufacturingMiningOther Services (except Public Administration)Professional, Scientific, and Technical ServicesReal Estate Rental and LeasingRetail TradeTransportation and WarehousingUtilitiesWholesale TradeBusiness Financial InformationEstimated gross annual revenues*Average bank balance*Assets to use as collateral*-- Select --Accounts receivableInventoryReal estateVehiclesOtherSpecify asset you wish to use as collateral*Do you currently have short-term financings?*-- Select --YesNoLender's name*Remaining balance*Personal InformationHome address*Home city*Home state*-- Select --AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaOntarioPrince Edward IslandQuebecSaskatchewanHome zip*Home country*-- Select --USACanadaPercentage of business owned*Majority ownership to be represented on application. Date of birth* YYYY dash MM dash DD Social security number*Estimated credit score*AttachmentsDrivers licenseUpload drivers license*Max. file size: 512 MB.Drivers license state*-- Select --AlabamaAlaskaSamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaVirgin IslandsWashingtonWest VirginiaWisconsinWyomingOntarioQuebecNova ScotiaNew BrunswickManitobaBritish ColumbiaPrince Edward IslandSaskatchewanAlbertaNewfoundland and LabradorDrivers license expiration date* DD dash MM dash YYYY Drivers license number*Consent* By submitting this application, you (i) authorize BorrowPartner LLC and/or its lending partners to use any credit bureau or business to verify the information that you provided, (ii) consent to receiving calls from BorrowPartner at the telephone number that you provided above, even if it is on a state, federal, or corporate Do-Not-Call registry, (iii) agree with BorrowPartner's Terms and Conditions; and (iv) acknowledge that you have read BorrowPartner’s Privacy Policy.Applicant's Full Name*Date*
