Fortun Funding Application
Revenue Finance Platform
Business Funding Application
Please complete all required fields marked with *
Application Details
Please read and check which applies to you *
One-Owner
, If the applicant business has only one owner, complete Owner Information (1) only. If the applicant business has multiple owners, each additional owner owning 30% or more of the business (or otherwise required by us) must complete an additional Owner Information section.
Multiple-Owners
, If the applicant business has multiple owners, each owner holding 30% or more of the business must complete an Owner Information section. We may also require additional owners to provide information if necessary to evaluate the application.
Date *
Intended Use of Funds *
Company Information
Legal Company Name *
Doing Business As (DBA)
State of Incorporation *
Select state
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
PR
Federal Tax ID *
Company Phone *
Company Email *
Company Web Site (URL)
Company Fax
Physical Address (no PO Boxes) *
Select state
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
PR
Business Inception Date *
Legal Entity *
Select type
Corporation
LLC
Sole Proprietor
PLLC
LLP
General Partnership
PA
Company Type/Industry *
Select industry
Automotive
Beauty / Personal Care
Business Services
Cleaning / Janitorial
Construction
E-commerce / Online Sales
Education / Childcare
Entertainment / Recreation
Fitness / Wellness
Healthcare / Medical
Home Services
Hospitality / Travel
Manufacturing
Pet Care / Veterinary
Professional Services
Real Estate Services
Restaurant / Food & Beverage
Rideshare & Limo Services
Retail
Transportation / Logistics
Wholesale / Distribution
Other
Outstanding MCA Amount *
Does your business have a separate bank account? *
Yes
No
Rent or Own? *
Select option
Rent
Own
Has your business collected credit cards for the last 3 months? *
Yes
No
Business Financial Overview
Your Annual Business Revenue *
Your Average Bank Balance *
Your Monthly Credit Card Volume *
Funding Amount Requested *
Owner Information (1)
Name *
Email Address *
Title *
Select title
Owner (Sole Proprietor)
Co-Owner (Sole Proprietor)
Member (LLC)
Manager (LLC)
President
Vice President
Chief Executive Officer (CEO)
Chief Operating Officer (COO)
Chief Financial Officer (CFO)
Director
Managing Partner
Trustee
Home Phone Number *
Cell Phone Number *
SS Number *
Immigration Status *
Select status
Citizen
Resident
Asylum Approved
Asylum Applied
TPS
Path to Legal
Visa
No Status
Date of Birth *
Annual Income *
Home Address (No PO Boxes) *
Select state
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
PR
Business Ownership % *
Signature *
Clear
Capture Signature
Terms and Conditions
By signing and submitting this application, you certify that (i) you are authorized to apply on behalf of the company whose full legal name appears above in this Revenue-Based Financing application, and (ii) all information provided in this application and any supporting documents is true, accurate, and complete. You agree to promptly notify us of any material changes to such information. You authorize us, our affiliates, agents, successors, and assigns to investigate and verify any information provided in connection with this application, including by obtaining business and consumer credit reports, bank verifications, merchant processing statements, and other financial information from credit reporting agencies, financial institutions, and other third-party sources. You further authorize us to obtain additional reports and make follow-up inquiries in connection with the servicing, renewal, modification, or extension of any financing provided. You also authorize us to share information regarding the undersigned individual(s) and the company with third parties, including funding partners, service providers, and financial institutions, as permitted by law, for the purpose of evaluating this application and offering financing and related financial products or services.
Submit Application