Small Business Loan Application

LenderMatch

Complete the application below to get matched with lenders offering revenue-based financing for small and mid-sized businesses.

Important Information About Procedures for Opening a New Account: To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account.

Please Email Completed Application to loanrequest@lendermatch.com

Contact Person

Full Name*

Email Address*

Phone Number

Legal/Corporate Name*

DBA (Doing Business As)

Physical Address

City

State

Zip

Mailing Address (if different from physical address)

City

State

Zip

Federal Tax ID (EIN)

Business Phone

Fax

Contact Person

Website

Date Business Started

Length of Ownership (in years)

Years at Location

# of Locations

Fields marked with * are required.

Authorization to Contact You By Phone: You authorize us, and our affiliates, agents and independent contractors, to contact you at any telephone number you provide to us or from which you place a call to us, or any telephone number where we believe we may reach you, using any means of communication, including but not limited to, calls or text messages to mobile, cellular, wireless or similar devices and calls or text messages using an automated telephone dialing system and/or artificial voice or prerecorded messages, even if you incur charges for receiving such communications.

Authorization to Contact You By Other Means: You also agree that we and our affiliates, agents and independent contractors may use any other medium, as permitted by law and including, but not limited to, mail, email, and facsimile, to contact you.