Business Funding Application

Business Information
Business Legal Name:
DBA:
Federal EIN:		Date Business Started:
Business Type: LLC Corporation Sole Proprietorship Partnership Other:
Business Address:
City:		State:
Zip Code:		Business Phone:
Owner / Applicant Information
Full Name:
Date of Birth:		SSN:
Home Address:
City:		State:
Zip Code:		Phone:
Email:
Ownership %:		Title / Position:
Additional Owner Information (if applicable)
Full Name:
Date of Birth:		SSN:
Home Address:
City:		State:
Zip Code:		Phone:
Email:
Ownership %:		Title / Position:

Credit Authorization and Disclosure

Credit Pull Notice: By signing below, you authorize Bluecore Capital Group to obtain a soft credit inquiry for the purpose of evaluating your funding application. A soft credit pull does not affect your credit score.

Certification: I certify that the information provided in this application is true, accurate, and complete to the best of my knowledge. I understand that any false statements or misrepresentation of facts may result in denial of funding and/or legal action. I acknowledge that it is a federal crime punishable under 18 U.S.C. § 1001 to knowingly and willfully make false statements to obtain funding or credit.

Applicant Signature

Primary Owner Signature:	Date:
Additional Owner Signature:	Date: