Apply for funding | Velo Capital Funding

Business Information

Legal Business Name

DBA / Trade Name

Federal Tax ID / EIN

Business Start Date

Date

Entity Type

Industry / Business Type

Business Website

Business Address

Street AddressCityState / ProvincePostal / Zip CodeCountry

Business Phone NumberPlease enter a valid phone number.

Business Emailexample@example.com

Primary Owner Information

Full Name

First NameMiddle NameLast Name

Title

Ownership Percentage

Date of Birth

Date

SSN / SIN

FICO

Mobile PhonePlease enter a valid phone number.

Email Addressexample@example.com

Home Address

Street AddressCityState / ProvincePostal / Zip CodeCountry

Additional Owner Information

Are there any additional owners with 20% or more ownership?

YesNo

Additional Owner Full Name

First NameLast Name

Title

Ownership Percentage

Date of Birth

Date

SSN / SIN

Mobile PhonePlease enter a valid phone number.

Email Addressexample@example.com

Home Address

Street AddressCityState / ProvincePostal / Zip CodeCountry

Funding Request and Bank Statements

Requested Funding Amount

Last 4 Months of Business Bank Statements

Declarations

I certify that the information provided is true and accurate to the best of my knowledge.

I authorize Velo Capital Funding to review the information provided for funding evaluation purposes.

I certify that the information provided is true and complete and authorize Velo Capital Funding and its assignees/designees to obtain business and personal credit reports and other information necessary to verify this application and evaluate financing.

Signature Full Name

By signing electronically, you agree to our E-Sign Consent and acknowledge our Privacy Policy.

Name

First NameLast Name

Name

First NameLast Name

Date Signed

Date

Review and Submit

Business Information

Legal Business Name: —
DBA / Trade Name: —
Federal Tax ID / EIN: —
Business Start Date: —
Entity Type: —
Industry / Business Type: —
Business Website: —
Business Address: —
Business Phone Number: —
Business Email: —

Primary Owner Information

Full Name: —
Title: —
Ownership Percentage: —
Date of Birth: —
SSN / SIN: —
FICO: —
Mobile Phone: —
Email Address: —
Home Address: —

Additional Owner Information

Are there any additional owners with 20% or more ownership?: —
Additional Owner Full Name: —
Title: —
Ownership Percentage: —
Date of Birth: —
SSN / SIN: —
Mobile Phone: —
Email Address: —
Home Address: —

Funding Request and Bank Statements

Requested Funding Amount: —
Last 4 Months of Business Bank Statements: —

Declarations: —
Signature Full Name: —
Name: —
Name: —
Date Signed: —

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Velo Capital Funding

Business Information

Primary Owner Information

Additional Owner Information

Funding Request and Bank Statements

Review and Submit

Business Information

Primary Owner Information

Additional Owner Information

Funding Request and Bank Statements

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Business Information

Primary Owner Information

Additional Owner Information

Funding Request and Bank Statements

Declarations and Consent