FUNDING APPLICATION

Apply for business funding.

Complete the application below for confidential review by Management. Have your business, ownership, processing, and insurance information ready.

GREATHOUSE FARMS CAPITALBUSINESS FUNDING

FUNDING APPLICATION

Business information

Business legal nameBusiness DBA name

Type of business entityIndustryState

Business street address

CityCountyStateZIP

Business location phoneFaxWebsite

Gross annual sales (previous year's tax return)Business start date (current ownership)Business Federal Tax ID

Own or rent business locationMonthly payment (if rented or mortgaged)Amount requested

Owner information

Legal first nameLegal last nameSSNDate of birth

Home street address

CityCountyStateZIP

Home phoneMobile phoneEmailOwn or rent home

Equipment / funding request

Equipment type / model or use of fundsEquipment cost / funding amount

Equipment description / business purpose

VendorVendor contact

Vendor street address

CityCountyStateZIP

Authorization and signatures

The undersigned certifies that all information supplied is true and complete and authorizes Greathouse Farms Co LLC, doing business as Greathouse Farms Capital, and its financing sources, service providers, representatives, successors, and assigns to obtain business and consumer credit reports, bank and trade references, public records, and other information reasonably necessary to evaluate, process, service, or enforce this business-purpose funding request. Submission does not obligate any source to approve funding. Approval, pricing, structure, documentation, collateral, insurance, and closing requirements are subject to underwriting and final written agreement.

Authorized signer's printed nameTitleDate

Authorized signature *

Draw Type

Not signed

Co-applicant / guarantor signature (if applicable)

Draw Type

Not signed

Confidential business-purpose funding application. Submission does not guarantee approval or financing.