Business Ownership Details

Next, we need some details about the owner(s) of the business. Please note: If the first owner owns less than 50% of the business, you'll be prompted to include additional owners.

Owner Contact Information

Owner Name *

First

Last

Birthdate *

M/D/YYYY

Owner Phone Number *

Social Security Number (SSN) - 9 DIgits *

Home Street Address *

City *

State *

Zip *

Are you a United States citizen? *

Business Information

Thank you for your interest in working capital from Reliant Funding, This Application process can be completed in 5 minutes...

Role *

What percent of the business do you own? *

What is the Legal Business Name? *

If the business operates under a different name, What is it? (Also called a DBA name.)

When was the Business Started? *

M/D/YYYY

Business Phone *

Business Address

Business Street Address *

City *

State *

Zip *

Let's Get to Know Your Business

Thank You! The information below will assist us in correctly evaluating your application and developing a customized funding offer.

What is the State of Incorporation for this business? *

What type of entity is the business? *

FEIN (Federal Employee Identification Number) *

Industry *

Business Statements *

Click or drag files to this area to upload. You can upload up to 15 files.

Please attach the last 12 months of your business statements (3 months minimum) Please include a current month to date screenshot.

Driver License *

Click or drag files to this area to upload. You can upload up to 15 files.

Please attach Copy of your driver's license (Back and Front)

Voided Check *

Click or drag files to this area to upload. You can upload up to 15 files.

Please attach Copy of a Voided Check from your business bank account

Ownership *

Click or drag files to this area to upload. You can upload up to 15 files.

Please attach Proof of Ownership (i.e. Articles of Incorporation or Secretary of State)

Signature *

Signature Name *

I agree to the Terms and Conditions

Business Ownership Details

Owner Contact Information

Business Information

Business Address

Business Funding

Let's Get to Know Your Business