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Information Form

Thank you for placing your trust in us. Please take a few minutes to complete the form below. We will process your request right away.

Contact Information

Please fill in the information above to hear back from one of our specialists, or continue to the questions below to check your eligibility and get started today.
Consent to Communications:

By providing your contact information and signing below, you authorize Premium Merchant Funding (PMF) and its representatives, successors, assigns, and designees to communicate with you via phone calls, text messages, and emails, including automated technology and pre-recorded messages, for informational, marketing, or transactional purposes. Standard message and data rates may apply. You may opt-out at any time by replying "STOP" to text messages, unsubscribing from emails, or contacting us directly. You further authorize PMF and its designees to obtain consumer, personal, business, and investigative reports about you from consumer reporting agencies (including TransUnion, Experian, Equifax, and Identity IQ), banks, creditors, government agencies, and other third parties (collectively, the "Recipients"). PMF may transmit this application form, along with any information obtained in connection with it, to any or all Recipients for purposes related to commercial loans or purchases of future receivables (collectively, "Transactions"). You also consent to the release, by any creditor or financial institution, of any information relating to you, to PMF and each of the Recipients. PMF is authorized to communicate with the Recipients on your behalf and represent you in matters related to the Transactions. Your information will be handled in accordance with our Terms of Use and Privacy Policy.

Business Details

Basic Documents

Drop a file or browse

Drop a file or browse

Supported formats are PDF, JPG, JPEG, PNG, TIFF, XLS, XLSX less than 10Mb
Please include last 4 month of business bank statements

Signature

Consent to Communications
By providing your contact information and signing below, you authorize Premium Merchant Funding (PMF) and its representatives, successors, assigns, and designees to communicate with you regarding your application and any related transactions, including via phone calls, text messages, and emails. These communications may include automated technology and pre-recorded messages. Standard message and data rates may apply. You may opt-out at any time by replying “STOP” to text messages, unsubscribing from emails, or contacting us directly.
Marketing Communications
Separately, you may choose to receive marketing messages (including special offers, product updates, and promotions) from PMF and its designees. By checking the box below or signing separately, you authorize us to send these marketing communications via phone calls, text messages, and emails, including automated technology and pre-recorded messages. Standard message and data rates may apply. You may opt-out of marketing messages at any time using the same methods described above.
Authorization to Obtain and Share Information
You authorize PMF and its designees to obtain consumer, personal, business, and investigative reports about you from consumer reporting agencies (including TransUnion, Experian, Equifax, and Identity IQ), banks, creditors, government agencies, and other third parties (collectively, the “Recipients”). PMF may transmit this application form, along with any information obtained in connection with it, to any or all Recipients for purposes related to commercial loans or purchases of future receivables (collectively, “Transactions”). You also consent to the release, by any creditor or financial institution, of any information relating to you, to PMF and each of the Recipients. PMF is authorized to communicate with the Recipients on your behalf and represent you in matters related to the Transactions. Your information will be handled in accordance with our Privacy Policy.
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