Contact – ZCBC

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Requested Amount

Business DBA

Date Established

Number of Employees

Type of Product/Service Sold

Total Monthly Sales (Average)

Business Structure

Use of Funds

Type of Entity

EIN # / Tax ID Number (9 Digits)

Business Type

Is This a Seasonal Business?

Total Monthly Card Sales (Average)

Business Name

State of Incorporation

Number of Locations

Time In Business (years)

Current Merchant Credit Card Processor Name

Average Bank Balance At End of Day

Business Address & Contact

Address

Address Line 1

City

State

Zip Code

Business Phone

Business Email

Lease / Own

Monthly Mortgage / Rent Payment

Other Credit Relationships

Do you have any open MCA Accounts?

MCA Remittance Balance

Loan Repayment Term

If Yes, MCA Funding Company Name

Do you have any outstanding loans?

Outstanding Loan Balance

MCA Estimated Term

If Yes, Lender Name

Loan Maturity Date

Owner / Applicant Information

Job Title / Position

Last Name

Home Phone (Optional)

Ownership Percentage (1-100%)

Email Address

Social Security Number (9 Digits)

First Name

Cell Phone

Date of Birth

Address

Address Line 1

City

State

Zip Code

Checkboxes

By checking here you agree that you have read and agree to Application Agreement, and Credit Profile Agreement (which authorizes ZCBCI to collect various types of information on your company, including background, consumer reports, credit checks, and credit card sales data)

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By checking here you agree that you have read and agree to E-Sign Consent Agreement

Contact Us

Ready to take your business to the next level? Contact us today for a free consultation.

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Business Address & Contact

Other Credit Relationships

Owner / Applicant Information

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