Looking for Cash for Your Business? Look on the Bright Side! Call Us 888-844-9974 Connect with Us on Facebook Connect with Us on LinkedIn Funding Application Business Legal Name Doing Business As Legal Entity CorporationLLCSole Proprietorship Federal Tax ID Business Phone Business Website Mobile Business Fax Email Address Business Start Date Physical Address City State Zip Code Mailing Address City State Zip Code Owner / Principal Information Name Last name % of Ownership Estimated Credit Score 700+649-699610-649580-609Below 580 Home Address City State Zip Code Email Mobile Date of Birth Social Security # 2nd Owner / Principal Information Name Last name % of Ownership Estimated Credit Score 700+649-699610-649580-609Below 580 Home Address City State Zip Code Email Mobile Date of Birth Social Security # Business Information Business Description Rented or Owned RentedOwned Open Bankruptcy? NoYes Monthly Rent/Mortgage Payment Landlord/Mortgage Company Contact Funding Information How much Capital is being requested? What is the Capital being requested for? (Please type all reasons how the capital is going to be used separated by commas) Visa/MasterCard Monthly volume Total Monthly Sales (All Forms of Revenue) Gross Annual Sales (Last Year’s Tax Return) Do you currently have a Cash Advance? If Yes, what is the current Outstanding Balance? Authorization The Merchant and Owner(s)/Officer(s) identified above (individually, an “Applicant”) each represents, acknowledges and agrees that (1) all information and documents provided to Bright Side Capital LLC including credit card processor statements are true, accurate and complete, (2) Applicant will immediately notify Bright Side Capital LLC of any change in such information or financial condition, (3) Applicant authorizes Brightside Capital LLC, LLC and its assignees to obtain personal, investigative, business, and consumer credit reports on the applicant (4) Applicant authorizes Bright Side Capital LLC to disclose all information and documents that Bright Side Capital LLC may obtain including credit reports to other persons or entities (collectively, "Assignees") that may be involved with or acquire commercial loans having daily repayment features or purchases of future receivables including Merchant Cash Advance transactions, including without limitation the application therefor (collectively, "Transactions"), and each Assignee is authorized to use such information and documents, and share such information and documents with other Assignees, in connection with potential Transactions, (5) Bright Side Capital LLC and each Assignee will rely upon the accuracy and completeness of such information and documents, (6) Bright Side Capital LLC, Assignees, and each of their representatives, successors, assigns and designees (collectively, “Recipients”) are authorized to request and receive any investigative reports, credit reports, statements from creditors or financial institutions, verification of information, or any other information that a Recipient deems necessary, (7) Applicant waives and releases any claims against Recipients and any information‐providers arising from any act or omission relating to the requesting, receiving or release of information, and (8) each Owner/Officer represents that he or she is authorized to sign this form on behalf of Merchant. A copy of this authorization may be accepted as an original. The term “Representative” shall mean any funding source looking to offer, make available, or provide to the Merchant access to loans or merchant cash advances based on such Merchant’s future receivables or sales and/or structured with a periodic repayment feature. I authorize Bright Side Capital LLC to use my information according to their Privacy Policy Full Name Date