Loan Application

470-531-1715 • info@zingfunding.com

Personal Data

First Name

Last Name

Phone

Email Address

Legal Business Name

Business Data

Street No.

Street Address

Unit/Floor/Suite

City

State

Zip

Inception Year

Inception Month

Tax ID (Test EIN auto-fills)

Type of Business

Website

Primary Loan Purpose

Requested Loan Amount

Type of Financing Request

Type of Company

Owner 1 Detail

First Name

Last Name

Email Address

Primary (Residential) Address

Street No.

Street Address

Unit/Floor/Suite

City

State

Zip

Date of Birth

Social Security Number (Test SSN shows score)

Percentage Ownership

Primary Guarantor?

Disclosure & Signatures

By signing and submitting your loan application, you certify that all information provided is true and complete. You authorize Nexus and its designated partners to obtain consumer and business credit reports, verify bank account information, and contact you regarding this request. Any electronic signature you provide has the same legal effect as a handwritten signature.

Owner 1

Print Name: —

Signature

Date

Owner 2

Print Name: —

Signature

Date