Apply Now FREE QUOTE Application for Fordham Capital loan. Trustpilot Step 1 of 3 - Business Information 0% Name* First Last Company Name*DBA (if different than Company name)Company Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Type of Business Entity*CorporationLLCPartnershipLtd. PartnershipLLPSole ProprietorPhoneFax #Email PhoneMonthly Revenue*less than $5,000$5,000 - $10,000$10,000 - $20,000$20,000 - $30,000$30,000 - $40,000$40,000 - $50,000$50,000 - $75,000$75,000 - $100,000$100,000 - $250,000$250,000 +Time in Business*less than 6 months6 months to 1 year1-2 years2-5 years5+ yearsIndustry*Medical Doctors/Chiropractors/Dentists/Other Health PractitionersHotels & MotelsHealth ServicesHome Health Care AgenciesLandscape/Horticulture/Lawn & Garden ServicesAmusement & RecreationPhysical Fitness FacilitiesBeauty ShopsGeneral Automotive Repair Shops/Auto Repair Services and GaragesManufacturing IndustriesRestaurants & BarsCaterersConstruction Sand & GravelGrocery StoresLiquor StoresRetail StoresSpecial Trade ContractorsPlumbing/Heating/and Air ConditioningGeneral Building & Single-Family Housing ContractorsNonresidential ConstructionWholesale Trade-Durable GoodsReal Estate Management CompanyInsuranceLaw FirmFinancial ServicesOtherBusiness Start Date (under current ownership)* Home Based BusinessFranchiseE-CommerceNone of the Above Does the Merchant have any open loan or MCA accounts*YesNoFederal Tax ID*Use of Proceeds*Business Locations*MortgageRentAvg Monthly Credit Card Volume*Avg Transaction Amount*Is Business Seasonal*YesNoIf Seasonal Peak Months Credit Score*Excellent (720+)Great (680-720)Good (630-680)Fair (580-630)Poor (500-580)Bad (500 or less)Any Open Bankruptcies?*YesNoAny Tax Liens?*YesNoSection BreakSecond Owner First/Last NameSecond Owner Percentage of Ownership Landlord Name/Mortgage Co. Name*Landlord/Mortgage Co. Phone*Business Trade Reference Name 1Reference #1 PhoneBusiness Trade Reference Name 2Reference #2 PhoneBusiness Trade Reference Name 3Reference #3 PhonePhoneThis field is for validation purposes and should be left unchanged.
