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Pacific Business Funding

GENERAL BUSINESS INFORMATION

BACKGROUND INFORMATION (Please explain any “Yes” answers)

OWNER(S)/LEGAL AGENT(S) INFORMATION

AUTHORIZATION TO RELEASE INFORMATION

The undersigned submits this APPLICATION to provide information necessary and to be related upon in assessing the potential of a commercial financing relationship, and states all information contained herein is true and accurate. The undersigned authorizes you, affiliates, assignees and other lending partners to investigate all information provided herein and any additional documentation supplied to you, and you are hereby authorized to check the credit and financial background of the company and the owners and officers. A photocopy, including fax copy, may be accepted as an original.

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