Submit Your Loan Application

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*Requires 3 Months of Most Recent Business Bank Statements

Your Business

Loan Information

Requested Loan Amount

Ownership Information

Primary Owner

Percent Owned

Ownership Information

Secondary Owner2

Percent Owned2

Documentation

Business Bank Statements
Upload 3 Months of Most Recent Statements
Authorization to Access Consumer Credit File and UCC
By checking the box below, you understand and hereby agree that you are irrevocably authorizing Breakout Capital, LLC, a Delaware limited liability company (“Breakout”), its agents, counsel, representatives, and/or service providers (collectively with Breakout, “Breakout Parties”) to obtain your individual consumer report, including your credit score, and other information, for the purpose of verifying your identity and processing this application for financing (including loans and/or factoring). By signing below, you, on behalf of yourself, each business listed in this Application and each subsequent business for which you request financing (including loans and/or factoring) be provided by Breakout or an affiliate thereof hereby irrevocably authorize each Breakout Party or applicable affiliate to file at any time from and after the date hereof one or more Uniform Commercial Code financing statements in such offices as may be necessary, or in Breakout’s judgment desirable, to perfect any security interests in favor of Breakout or any affiliate thereof with respect to any or all personal property, assets and/or fixtures of each such authorizing party.
Financing Application Acknowledgement
By submitting this application, you specifically represent to Breakout (the “Financing Party”) and agree and acknowledge that: (1) the information provided in this Financing Application and other requested and required information for the purposes of obtaining financing (including loans and/or factoring) is true, accurate, and complete as of the date this application is submitted for a credit or funding decision; and (2) the Financing Party has not made any commitment to approve the Financing Application or make any offer for funding, unless otherwise agreed to in writing.
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