Cashberry

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BUSINESS INFO
PERSONAL INFO

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How soon would you like the money?*
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What will you use the money for?*
First name:*
Last name:*
Primary phone number (mobile):*
Your email address:*
How much funding can we help you with?*
What is your approximate MONTHLY revenue:*
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What are your monthly sales:
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How did you hear about us?
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Please specify
Where did you hear about us?
By clicking "Next", you consent to Cashberry or one of its affiliates contacting you regarding your application.

By clicking “Next”, you to consent to Cashberry or one of its
affiliates contacting you regarding your application.

Legal Business Name:*
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Do you do business under a different name?
- Yes
- No
Please specify the other name you do business under?
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Street Address City State / Province / Region ZIP / Postal Code Country
Business phone number:
Entity type:*
What year did you start your business?*
What industry are you in?*
Where is the business incorporated (select State)?
What is your average bank balance:
Do you currently have any other financing?*
- Yes
- No
How much is owed?
What is the business's Tax ID or EIN:*

By clicking “Next”, you to consent to Cashberry or one of its
affiliates contacting you regarding your application.

Home Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Home phone:
Date of birth :*
What is your credit score?*
Percent of the business you own*
Please enter a number from 1 to 100.
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Is there another person in your company that has significant responsiblities for managing a business?*
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Is there another person in your company that has significant responsiblities for managing a business?
- Yes
- No
Social security number:*
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- By checking here you agree that you have read and agree to the CashBerry E-sign Consent Agreement.
By signing below, each of the above listed business and business owner/officer, individually and collectively, ("you"') authorize Cashberry, LLC ("Cashberry") and each of its representatives, successors, affiliates, assignees and designees to obtain consumer or personal, business and investigative reports and other information about you, including credit card processor statements and bank statements, from one or more consumer reporting agencies, such as TransUnion, Experian and Equifax, Identity IQ and from other credit bureaus, banks, creditors, government agencies and other third parties (the "Recipients"). You also authorize Cashberry to transmit this application form, along with any of the foregoing information obtained in connection with this application, to any or all the Recipients for the foregoing purposes. You also consent to the release, by any creditor or financial institution, of any information relating to any of you, to Cashberry and to each of the Recipients, on its own behalf and authorize Cashberry to communicate with the Recipients on your behalf and represent you with the Recipients. You also authorize Cashberry and each of its Recipients to contact you via phone call, textmessage, automated call or email message at the contact information listed above.
Signature*
Please sign with your finger or mouse and then click “Submit”.

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