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Superior Commercial Funding, Inc
760 US Highway 1, Suite 303
North Palm Beach, FL 33408
Phone: (561)626-3420 or (844)626-FUND (3863) • Fax: (844)562-0040

Secure Commercial Financing Application

Business Information
                   
 Company Name
 Business Phone  Business Fax
 Business Address  City  State Zip
 Federal I.D. No   Incorporation Date  Type of Incorporation/Ownership
 Alternate Phone Number:  Amount Requested:  Type of Business:

 

Owner 1
                   
 FULL LEGAL NAME:
 First Name  M.I.  Last Name:
 Title  Ownership %  SSN DOB
 
 Home Phone  Cell Phone  Alternate Phone  
 Email Address
 Home Address  City  State Zip

 

Owner 2
                   
 FULL LEGAL NAME:
 First Name  M.I.  Last Name:
 Title  Ownership %  SSN DOB
 
 Home Phone  Cell Phone  Alternate Phone  
 Email Address
 Home Address  City  State Zip

 

Financial Needs
                   
Please describe what your financial needs are (be specific).
 
 Terms of Financing  Puchase or Contract Price:
 Has Any Owner/Officer filed Bankruptcy in the last 7 Years? Yes No
 Do you have collateral that you would like to pledge? Yes No
 If so, please describe items with estimated value:

 

By checking this box, the Applicants represent and warrant that all credit and financial information submitted is true and correct and that Superior Commercial Funding, Inc may obtain any credit information necessary pertaining to this application.

Submitting this application is equivalent to a signature.