Working Capital Business Information Legal Business Name * Doing Business As Name (DBA) * Business Address * Business Address Business Address Business Address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Business Address Business Phone * Business Email * Legal Business Structure (Select One) * Sole ProprietorshipPartnershipCorporationLLCOther Legal Business Structure (Select One) Business Start Date * Business Type / Services Provided * Landlord Name * Landlord Phone * Business Financial Information Federal Tax ID Number * 9 digits State of Incorporation * Requested Funding Amount * Purpose of Funds * Do you currently have a cash advance balance open with another company? * YesNo Company 1 * Current Balance * Date Received * Company 2 * Current Balance * Date Received * Principal Owner Information #1 Name * Name First First Last Last Percent Ownership (%) * Home Address * Home Address Home Address Home Address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Home Address Birthdate * Social Security Number * Phone Number * Email * Principal Owner Information #2 Name * Name First First Last Last Percent Ownership (%) * Home Address * Home Address Home Address Home Address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Home Address Birthdate * Social Security Number * Phone Number * Email * The Business Applicant and each Principal, person or entity signing this Application or an Application Addendum Form (“Signer”) represents, acknowledges and agrees as follows: (i) all information provided to Small Business Financial Solutions, LLC, Toroide Capital Services, INC and [or] their corporate affiliates (collectively “Toroide Capital”) by Signers is true and complete; (ii) in the event Toroide Capital declines to extend financing to the Business Applicant, Signers authorize Toroide Capital to disclose all information and documents that Toroide Capital may obtain regarding Signers (whether from Signers or third parties) to other persons or entities that are under contract with Toroide Capital for the purpose of providing financing to applicants that Toroide Capital does not provide financing (collectively “Recipients”); and (iii) Signers authorize Toroide Capital and Recipients to: 1. obtain credit and employment information about the Signers; 2. obtain credit reports and make any inquiries Toroide Capital and Recipients consider appropriate in connection with this Application or reviews of the Applicant’s account from time to time; 3. disclose account information as required by law. Each Signer acknowledges that additional information may be required in order to render a decision regarding Business Applicant’s account and Signers hereby certify that they have read and understand the terms of this Toroide Capital Application Form. EACH SIGNER ACKNOWLEDGES THAT TOROIDE CAPITAL MAY RELY ON THE STATEMENTS AND INFORMATION SET FORTH IN THIS APPLICATION AND THAT SUCH STATEMENTS AND INFORMATION MAY BE INCORPORATED BY REFERENCE IN ANY AGREEMENT ANY OF THE UNDERSIGNED MAY ENTER INTO WITH TOROIDE CAPITAL. EACH OF THE UNDERSIGNED HEREBY AGREES TO NOTIFY TOROIDE CAPITAL PROMPTLY OF ANY CHANGE IN ANY SUCH STATEMENT OR INFORMATION. EACH SIGNER HAS READ AND UNDERSTANDS THE TERMS OF THIS APPLICATION, INCLUDING ANY ADDENDUM, AND REPRESENTS AND WARRANTS THAT THE INFORMATION CONTAINED HEREIN IS TRUE AND CORRECT. By signing this Application, you authorize Toroide Capital and prospective third party funding providers to contact you at the numbers you provide (including mobile) during any step of this application, via phone (including automated telephone dialing system, prerecorded, SMS and MMS means) even if you are on a Do Not Call Registry. You are not required to agree to be contacted in this manner to use Toroide Capital’s services. Applicant’s Print Name * Applicant’s Signature * signature keyboard Clear Date * Co-Applicant’s Print Name Co-Applicant’s Signature signature keyboard Clear Date * CAPTCHA If you are human, leave this field blank. Submit
