Business Funding Application Mobile 1

Need Help? Call 855-850-2176

Name *

First

Last

Phone # *

*only numbers (no spaces or special characters)

Email *

What is your gross monthly revenue? *

$1-10,000
$10,000 - $25,000
$25,000 - $50,000
$50,000 - $100,000
$100,000-$250,000
$250,000-$500,000
$500,000+

Use of funds *

Acquire a new business
Bridge Payments
Hire New Employees
Payroll
Purchase Real Estate
Remodel
Other

How much do you need? *

Do you own Commercial Real Estate? *

Do you have Accounts Receivable? *

When do you need funding by? *

ASAP
1-3 days
1 week
1 month

Business Name (D.B.A.) *

Tax ID#

*only numbers (no hyphens or spaces)

Social Security # (SSN)

*A soft credit pull will be done. It will not show up or affect your credit score. (numbers only)

Corporate Name (If Different)

Address Line 1 *

Address Line 1

City *

City

State *

Zipcode *

Zipcode

Industry *

Let's learn a little bit about your business. Select all that apply. *

Accept credit cards
Have a prior bankruptcy
Operate as a franchise
Invoice customers
Operate as a non-profit
Do business seasonally
Use a tool for bookkeeping

Entity Type *

LLC
Partnership
International org.
Medical/Legal corp.
Tax exempt
Government

Updating preview…

This is a preview of your submission. It has not been submitted yet!
Please take a moment to verify your information. You can also go back to make changes.

Terms & Conditions *

I consent to receive emails, phone calls and/or text messages, including autodialed and pre-recorded calls, for marketing purposes, from Biz-Pay and its participating partners at the phone number and email address I provided. I acknowledge that consent is not a condition of purchase and that telephone calls to and from Biz-Pay or its partners may be recorded. Message and data rates may apply. I understand I may opt out at any time. I acknowledge that I have read the Credit Gathering Authorization terms as well as the terms and privacy of this website.

Optional Bank Statements' Uploads For The Past 3 Months

*For quicker approval and more accurate funding, you can upload 3 files of your most recent bank statements in the past 3 months... but you don't have to!

Month 1 Bank Statement (most recent)

Click or drag a file to this area to upload.

Month 2 Bank Statement

Click or drag a file to this area to upload.

Month 3 Bank Statement (least recent)

Click or drag a file to this area to upload.

Company

Learn

Key Features

Terminals

Instant Line of Credit

CBD

DSAA

Contact

3220 Tillman Dr, Suite 200

Bensalem, PA 19020

855-850-2176

info@biz-pay.com

Company

Learn

Key Features

Terminals

Instant Line of Credit

CBD

DSAA

Contact

3220 Tillman Dr, Suite 200

Bensalem, PA 19020

855-850-2176

info@biz-pay.com

Biz-Pay® is an associated partner of a registered Independent Sales Organization of Wells Fargo Bank, N.A., Concord, CA. and Esquire Bank, N.A., Jericho, NY. Designated trademarks and brands are the property of their respective owners. American Express may require separate approval. The Clover name and logo are owned by Clover Network, Inc. a wholly-owned subsidiary of First Data Corporation, and are registered or used in the U.S. and many foreign countries.