Business Credit Questionnaire

Details
Thank you for choosing RippleBrand.com. We look forward to helping you reach your business goals. Please fill out this form to begin the process. We understand that you may not have all of the information at hand at this time. Fill out what you can and you can send the remaining information on this same form one you get it.

* Indicates required field

Financing Request Amount *

Borrowing Entity Name *

Doing Business As *

Business Address *

Line 1

Line 2

City

State

Zip Code

Country

Applicant Entity Type (Corporation, LLC, Sole State of Incorporation Date of Incorporation Proprietor, etc.) LLC *

State of Incorporation *

Date of Incorporation *

EIN (or SSN of Sole Proprietor) *

Primary Business Activity *

Type of Financing *

Time in Business *

Average Monthly Income (last 3 mths) *

Other Business Loans? *

Yes No

Loan Balance *

Principle(s)

Name *

First

Last

Name *

First

Last

Email *

Phone Number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Address *

Line 1

Line 2

City

State

Zip Code

Country

Collateral (If Any)

Address *

Line 1

Line 2

City

State

Zip Code

Country

Value *

Description *

When Purchased *

Purchase Price *

Amount Owed *

Owed to *

When Due *

In Default? *

Yes No

Purchase Price *

Upload ID *

Max file size: 20MB

Upload Bank Statement *

Max file size: 20MB

Upload Bank Statement *

Max file size: 20MB

Upload Bank Statement *

Max file size: 20MB

Documents Explanation *

(“Signer”) acknowledges, agrees and certifies that each Client, and each individual associated with such Client (including an owner or other principal) hereby provides RippleBrand.com (RB) with authorization pursuant to which:

(a) Client, has authorized RB to share and disclose information regarding the Client, with potential lenders, including without limitation financial statements, tax returns and tax identification and social security numbers
(b) Client acknowledges and agrees that potential lenders may obtain information about the client, from third parties, including consumer reports and credit scores from consumer reporting agencies
(c) Client authorizes RB to receive communications from potential lenders regarding any applied for loan, including notices of "adverse action" under applicable law or similar communications disclosing information regarding the Client.

Each person or entity signing (including digital signature) this Questionnaire (individually and together, “Signer”) represents, acknowledges, and agrees as follow; (I) Signer has all necessary authority to execute this document; (II) all information provided to RippleBrand.com (RB) by Signer is true and complete; (III) RB may rely on the statements and information set forth in this Questionnaire and such information may be incorporated by reference in any agreement Signer may enter into with RB; (IV) Signer agrees to notify RB of any change in any statement or information set forth in this Questionnaire; (V) Signer authorizes RB to conduct background checks, including consumer reports, credit scores from consumer reporting agencies and criminal records, and make any inquiries RB considers appropriate, from time to time, in connection with this Questionnaire or reviews of Signer and/or any of the individuals listed in this Questionnaire; and (VI) Signer authorizes RB to contact Signer at the numbers provided above, via phone (including automated, pre-recorded, SMS, and MMS means), even if Signer is on a Do Not Call Registry. Signer is not required to agree to be contacted in this manner to use RB’s services. (VII) Signer agrees to pay an upfront, nonrefundable consulting fee of $999 and a commission of 5% of the final loan amount to RB. The upfront fee will be deducted from the final commission. (VIII) Signer agrees, accepts and understands that RB is not a lender or Mortgage broker. RB's service is Business consulting.

Signer hereby acknowledges that the information provided is true and correct. *

Check this box to agree & confirm.

Digital Signature *

Date *

Submit