Working Capital Financing Application Step 1 of 4 - Basic Information 25% This application is required for Working Capital Financing, including Business Loans, Business Lines of Credit, and Revenue-Based Financings. Our simple working capital application takes you through 3 easy pages to gather information about you, your business, and the business performance. It then allows you to upload copies of the documents required to apply. It generally takes between 5 and 10 minutes to complete. There are no fees and no obligations to apply. And, applying for business financing with i95 Capital will not affect your personal credit score. Apply now below for super fast processing! Of course, any questions, at any time, simply contact us. We are always happy to assist. Really! * All fields are required Unique IDName* First Last Email* Password* Enter Password Confirm Password Between 8–30 characters, and should include both upper and lower case letters, at least one number, and at least one symbol or special character. Phone*How did you hear about us?*-- Select --AffiliateEmailInternet SearchFriendOtherAffiliate IDEnter the Affiliate’s 6-digit Identification Other*Funding Amount Requested*Term Requested-- Select --6 months12 months15 months18 months2 years3 years4 yearsFinancing Requested*-- Select --Business LoanBusiness Line of CreditRevenue-Based FinancingHow soon will you use the financing?*-- Select --3 days1 week2 weeks4 weeksmore than 1 monthUse of Funds*Note: Your business is applying for credit and not for a specific credit product, amount, or term. Any credit offered will depend on the credit and underwriting standards of the lender. Almost halfway there, but remember: Any questions, at any time, simply contact us. We are always happy to assist. Really!Business InformationLegal Business Name*DBA (if different)Business Address*Business City*Business State*-- Select --AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaOntarioQuebecPrince Edward IslandSaskatchewanBusiness Zip Code*Business Country*-- Select --USACanadaBusiness Phone*Business WebsiteLegal Entity Type*-- Select --CorporationGeneral PartnershipLimited Liability CorporationLimited Liability PartnershipSole ProprietorshipState of Incorporation*-- Select --AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaNew BrunswickBritish ColumbiaManitobaNova ScotiaNewfoundland and LabradorOntarioPrince Edward IslandQuebecSaskatchewanBusiness Start Date* MM slash DD slash YYYY Use the dropdown date pickerBusiness Tax ID*Is the business in active bankruptcy?*-- Select --NoYesIndustry*-- Select --Business to Business ServicesConsumer ServicesConstructionDistributionFarmingEngineeringEntertainmentFood & BeverageFranchiseHealthcareHospitalityLogisticsManufacturingPersonal ServicesProfessional ServicesRestaurantsTechnologyTradeOtherRetailTransportationWaste ManagementWholesaleBusiness Financial InformationEstimated Gross Annual Revenues*Average Bank Balance*Do you currently have other short-term financings?*-- Select --YesNoLender's Name*Remaining Balance* Almost done... See this is easy! * All fields are requiredPersonal InformationHome Address*Home City*Home State*-- Select --AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaOntarioPrince Edward IslandQuebecSaskatchewanHome Zip*Home Country*-- Select --USACanadaHome Ownership*-- Select --OwnRentDate of Birth* MM slash DD slash YYYY Use the dropdown date pickerSocial Security Number*Estimated Credit Score*Job TitlePercentage of Business OwnedMajority ownership to be represented on application. Update your documents, click the Submit button, and you are done! * Required DocumentsAttachmentsBank StatementsUpload bank statement #1*Max. file size: 2 GB. Month*-- Select --JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberYear*-- Select --20252026Upload bank statement #2*Max. file size: 2 GB. Month*-- Select --JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberYear*-- Select --20252026Upload bank statement #3*Max. file size: 2 GB. Month*-- Select --JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberYear*-- Select --20252026Drivers LicenseUpload Drivers License*Max. file size: 2 GB. Drivers License State*-- Select --AlabamaAlaskaSamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaVirgin IslandsWashingtonWest VirginiaWisconsinWyomingOntarioQuebecNova ScotiaNew BrunswickManitobaBritish ColumbiaPrince Edward IslandSaskatchewanAlbertaNewfoundland and LabradorDrivers License Expiration Date* MM slash DD slash YYYY Use dropdown date picker Drivers License Number*Voided CheckUpload voided check*Max. file size: 2 GB. Optional DocumentsBusiness taxes Last year's business taxes Year*-- Select --20242025Last year's busines taxes*Max. file size: 2 GB. PS1 Processing Statement 1 Processing Statement 1*Max. file size: 2 GB. Month*-- Select --JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberYear*-- Select --20252026PS2 Processing Statement 2 Processing Statement 2*Max. file size: 2 GB. Month*-- Select --JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberYear*-- Select --20252026PS3 Processing Statement 3 Processing Statement 1*Max. file size: 2 GB. Month*-- Select --JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberYear*-- Select --20252026By submitting this application and entering your name below, you (i) authorize Number72 LLC (i95Capital.com) and its lending partners to use any credit bureau or business service to verify the information you provided; (ii) consent to receiving calls from Number72 LLC at the telephone number provided above, even if that number is listed on a state, federal, or corporate Do-Not-Call registry; (iii) acknowledge that you are not required to provide this consent as a condition of receiving any credit or services from Number72 LLC, and that you may apply for financing by contacting us directly; (iv) agree to Number72 LLC's Terms and Conditions; and (v) confirm that you have read Number72 LLC's Privacy Policy.Applicant's Full Name*Date*