APPLY FOR FUNDING

# __ _____Date:___________.
>> Transparency Funding Qualificatin Applicatin
Please fill in the spaces below and mail or fax us the application. By doing so, you are giving Transparency Funding! as well as its agents and
affiliates, permission to review your business and personal credit history in order to provide you with formal funding approval.
"usiness Legal Na#e$ "usiness D"A Na#e$
Address$ %uite&Flr$
'ity$ %tate$
(ip$ P)ne$
*+ile$ Fa,$
-e+site$ .#ail$
Legal .ntity$ 'rp %le Prp LL' Partners)ip Type f "usiness$ 'rp %le Prp LL' Partners)ip
Federal %tate Ta, / Landlrd&*rtgage '#pany$
A#e, / Rent&*rtgage Pay#ent$
Disc0er / Landlrd 'ntact Na#e$
'redit 'ard Ter#inal Type$ Landlrd 'ntact P)ne$
>> O1ner&Principle Infr#atin
Na#e $ Date f "irt)$
Address $ 'ity$
%tate$ (ip$
P)ne$ Fa,$
.#ail $ *+ile$
2f O1ners)ip$ %%N/$
>> Funding Infr#atin
A0erage Grss *nt)ly %ales$ A0erage 3isa&*aster'ard *nt)ly %ales$ A0erage Tic4et %i5e$
'ard %1iped$ 2 'ard 6eyed In$ 2 Internet Accunt$ Yes&N
7a0e yu used a cas) ad0ance plan +efre8$ Y.% NO "alance$ 9if applica+le:
D yu use$ 9c)ec4 all t)at apply: ')ec4 reader Gift 'ards ."T
Type f Prducts %ld$
By Signing below, the Merchant and its owners / principals: (1) certify that all information and documents submitted in connection with this
Application is true, correct and complete and (!) authori"e, its agents, partners and lenders to recei#e credit reports and any other
information regarding the Merchant and its owners and principals from third parties, to #erify any information pro#ided on the Application$
By:%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%/%%%/%%%%%%%%%
Applicants Signature Date
&
Transparency Funding
375 Diablo Rd Suite 101 Danville Ca !5"#