Ikahn Application (1)
- 1. If you have any questions, please call me at (646)774-0210 or email moek@ikahncapital.com BUSINESS INFORMATION Legal/Corporate Name: DBA: Physical Address: City: State: Zip: Telephone # Fax #: Federal Tax ID: Date Business Started: Length of Ownership: Website: Type of Entity (circle one): Sole Proprietorship Partnership Corporation LLC Other Email Address: What does your business do? Product/Service Sold: MERCHANT/OWNER INFORMATION Corporate Officer/Owner Name: Title: Ownership %: Home Address: City: State: Zip: SSN: Date of Birth: Home #: Cell#: PARTNER INFORMATION Partner Name: Title: Ownership %: Have you ever declared Bankruptcy? Home Address: City: State: Zip: SSN: Date of Birth: Home #: Cell #: BUSINESS PROPERTY INFORMATION Business Landlord or Business Mortgage Bank: Contact Name and/or Account #: Phone #: BUSINESS TRADE REFERENCES (Please list at least 3 trade suppliers. Please attach any additional references on a separate page.) Business Name: Contact, Account # or Fax #: Phone #: Business Name: Contact, Account # or Fax # : Phone #: Business Name: Contact, Account # or Fax #: Phone #: OTHER INFORMATION Credit Card Processing Terminal(s)/Software Model: Number of Terminals: Avg. Monthly Credit Card Volume Avg. Monthly Gross Sales Volume Requested Advance Amount: Use of Funds: Please circle all payment types you accept: Visa/MasterCard Amex Discover Debit EBT Prior/Current Cash Advance Company (if applicable): Balance: Underwriter Use Only Split Funds __ ACH __ Applicant(s) authorizes Ikahn Capital, LLC and its assigns, agents, banks or financial institutions to obtain an investigative or consumer report from a credit bureau or a credit agency and to investigate the references given on any other statement or data obtained from applicant. ________________________________________________________ __________________________________ Applicant’s Signature Date ________________________________________________________ __________________________________ 2nd Applicant’s Signature Date Please complete and send back WITH 3 MONTHS BANK STATEMENTS Email to moe@ikahncapital.com