Apply Now – Application For Dade Strategic

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1Business Info

2Owner Info

3Funding Info

4Trade References

5Important Questions

6Signatures

7Final Steps

Application for business transaction funding.
The fastest way to funding is to fill out the fields below and drop 6 months bank statements in the Dropbox at the end of the Pre-Qualification Application. If your pdf bank statement is over 12MB then email them to [email protected]. By doing so, you are giving DSS Funding, as well as its agents and affiliates, permission to review your business credit history in order to provide you with formal funding approval.
Business Legal Name*
Business DBA Name*
Type of Business Entity?*
Business Address*
Street Address City State Zip Country
Is Mailing Address Different?*
- Yes
- No
Mailing Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Mobile Phone Number*
Business 2nd Phone Number*
Office Number
Business Fax
Business Email Address*
What email do you use for business correspondence?
Enter Email Confirm Email
Current Website
Type of Business / Products Sold*
Number of employees*
Federal Tax ID #:*
Business Start Date (MM/DD/YY):*
type in date
Month
Day
Year
Property Ownership*
- Lease
- Own
Rent Payment*
Landlord Company*
Landlord Contact Name*
Landlord Phone Number*
Mortgage Payment*
Mortgage Company*

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OWNER / PRINCIPAL INFORMATION
Owner First Name*
Owner Last Name*
Percent of Ownership*
Please enter a number from 1 to 100.
Home Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Home Phone*
Home Fax:
Mobile Phone Number*
Email Address*
Date of Birth*
type in date
Month
Day
Year
Social Security Number*
Drivers License Number*
Drivers License State of Issuance*
Owner / Principal Information #2
Owner 2 First Name*
Owner 2 Last Name*
Owner 2 Percent of Ownership*
Please enter a number from 1 to 100.
Owner 2 Home Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Owner 2 Mobile Phone*
Owner 2 Home Phone Number*
Owner 2 Home Fax Number
Owner 2 Email Address*
Owner 2 Date of Birth*
type in date
Month
Day
Year
Owner 2 Social Security Number*
Owner 2 Drivers License Number*
Owner 2 Drivers License State of Issuance*

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The information supplied in this confidential financing application, company profile form, and all forms and documents submitted (collectively the Application) to Dade Strategic Syndication, its subsidiaries or its Assignee (collectively Factor) in connection herewith is true and correct to the best of my/our knowledge and belief. In compliance with the Fair Credit Reporting Act, I/ we authorize Dade Strategic Syndication, and/or its participating Factors to investigate my/our business and personal credit through its various agencies for the purpose of evaluation and verification. If this application is printed and faxed, hand signatures are required, but if this form is submitted securely, or typed name(s) in the fields provided serve as original signature(s). Incorporate U.S. Public Law 106-229, ‘‘Electronic Signatures in Global and National Commerce Act’’ or such other applicable law conforming to the UNCITRAL Model Law on Electronic Signatures (2001) and ELECTRONIC COMMERCE AGREEMENT (ECE/TRADE/257, Geneva, May 2000) adopted by the United Nations Centre for Trade Facilitation and Electronic Business (UN/CEFACT). EDT documents shall be subject to European Community Directive No. 95/46/EEC, as applicable. Either Party may request hard copy of any document that has been previously transmitted by electronic means provided however, that any such request shall in no manner delay the parties from performing their respective obligations and duties under EDT instruments.

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Application for business transaction funding.

OWNER / PRINCIPAL INFORMATION

Owner / Principal Information #2

Funding Information

Trade References

Important Questions

Signatures

Bank Statements Upload