Business Name *

Business Email Address *

Business Phone Number *

Business Address *

You must have an active C-Corp or LLC in order to obtain business capital. Is your entity currently active with the Secretary of State where your entity was registered? (Please verify your entity is active on your Secretary of State's website. If it is not active, we would have to assist you on getting it active before moving forward with funding.) *

Yes

Did you sign up for NAV so that we can access your business credit reports? *

Yes

Did you sign up for MYSCORESHIELD so that we can access your personal credit reports? *

Yes

Email address to login for NAV *

Password to login for NAV *

Email address to login for MYSCORESHIELD *

Password to login for MYSCORESHIELD *

EIN (Employer Identification Number) *

Annual or projected revenue *

Industry Type *

Company Structure *

Do you have a Dunns and Bradstreet number? If so, list below

Do you have direct or indirect ownership of at least 25% of the business? *

Yes

Years in Business *

Number of employees *

Estimated monthly spend if approved for business credit *

Role in company *

Do currently have any business credit cards? *

Yes

If you answered "YES" to the question above, please list any open/closed business credit cards in the space below.

Full Name *

Address *

Mother's maiden name *

Date of birth *

Social Security Number *

Total Annual Income *

Non-taxable annual income

ACH AUTHORIZATION AGREEMENT FOR PAYMENT ON APPROVED BUSINESS/CORPORATE CREDIT APPROVALS.

I "the client" authorize Credible Concepts to charge my bank account immediately on APPROVED business/corporate credit applications and/or corporate credit establishment for compliance on my behalf from services provided by Credible Concepts.

By completing this application, you authorize Credible Concepts to submit your application to determine if you are approved for any business credit or corporate credit offers and you acknowledge that 1. This is not an application for credit, 2. Third party lending institutions may review your recent credit history and/or other information and 3. identification of pre-qualified offers does not guarantee account approval. The overall purpose of this application is apply for business and/or corporate credit on your behalf with the requested information. Please note that if you should wish for us to move forward and apply for any business credit on your behalf that requires a personal guarantee, you may be subject to a hard pull on your credit report(s) from third party lenders.

FEES: Credible Concepts Inc. charges an 10% success fee upon the completion of any VISA/Mastercard/American Express applications that results in an approval for business credit.

By signing, you understand and agree the above text. *

Clear

Billing Name *

First
Last

Billing Address *

Street Address
Street Address Line 2
City
State
Postal / Zip Code

Bank Name *

Bank City/State *

Bank Routing Number *

Bank Account Number *

Notice of Hard Inquiries/Cancellation/Returned Payments

NOTICE OF HARD INQUIRIES

By signing this application, I agree that I fully understand and that I am aware of the possibility of one or more inquiries that appear on my credit report(s) as a result from Credible Concepts Inc. applying for business credit on my behalf after I have pre qualified for any business credit.

CANCELLATION/RETURNED PAYMENTS

I understand that this authorization will remain in effect until I cancel it in writing, and I agree to notify Credible Concepts in writing of any changes in my account information or termination of this authorization at least 15 days prior to the next billing date. If the above noted periodic payment dates fall on a weekend or holiday, I understand that the payment may be executed on the next business day. I understand that because this is an electronic transaction, these funds may be withdrawn from my account as soon as the above noted periodic transaction dates. In the case of an ACH Transaction being rejected for Non Sufficient Funds (NSF) I understand that Credible Concepts may at its discretion attempt to process the charge again within 30 days, and agree to an additional $25.00 charge for each attempt returned NSF which will be initiated as a separate transaction from the authorized recurring payment. I acknowledge that the origination of ACH transactions to my account must comply with the provisions of U.S. law. I agree not to dispute this recurring billing with my bank so long as the transactions correspond to the terms indicated in this authorization form.

By signing, you understand the above text. *

Clear

I Consent to Receive SMS Notifications, Alerts & Occasional Marketing Communication from company. Message frequency varies. Message & data rates may apply. Text HELP for assistance. You can reply STOP to unsubscribe at any time.