Apply for Funding.

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Funding ApplicationSecure Intake

Business Information

Business Name *

Business Address *

City *

State *

ZIP *

Business Phone *

Business Email *

Company Type *

Business Start Date *

Industry Type *

Business Bank Accounts

Application Referrer

How Are You Processing Payments

Current Processor

Do You Have a Contract With Your Current Processor?

YesNoUnsure

Funding Request

Requested Funding Amount *

Gross Revenue *

Purpose of Requested Funds *

Current Loans or Advances and Balances

Any Tax Liens

Documents

Bank Statement, Month 1 *

Bank Statement, Month 2 *

Bank Statement, Month 3 *

Bank Statement, Month 4 *

Month to Date, Current Month

Your most recent activity. PDF preferred.

Voided Check

Or enter your account and routing numbers below.

Account Number

Routing Number

Driver's License, Front *

Driver's License, Back *

Ownership

Owner 1 Full Name *

Ownership % *

Home Address *

Home Phone *

Email *

Social Security Number *

Date of Birth *

Agreement

I certify that the information provided in this application is true and complete. I authorize Batch Capital to verify the information provided, including obtaining business and personal credit reports, and to contact me about this application.

Signature *

Sign above with your mouse or finger.

Date

Your information is transmitted securely and used only to underwrite this application.