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Business Address*
Business Start Date*

Owner's Information

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Second Owner's Information

Legal Name
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Date of Birth
Home Address
Disclosure*
Authorizations: The Merchant and Owner(s)/Officer(s) identified above (individually, an “Applicant”) each represents, acknowledges, and agrees that (1) all information and documents provided to King Capital (“KC”) are true, accurate, and complete, (2) Applicant will immediately notify KC of any change in such financial condition, (3) KC and it’s affiliates are authorized to request and receive any investigative reports, credit reports, statements from creditors or financial institutions, verification of information, or any other information that KC and it’s affiliates deem necessary, (4) Applicant waives and releases any claims against KC and any information-providers arising from any act or omission relating to the requesting, receiving, or release of information, and (5) each Owner/Officer represents that he or she is authorized to sign this form on behalf of Merchant.
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45 Broadway - Suite 3120
New York, NY 10006


Email: info@kingcapitalnyc.com


Tel: (888) 811-6101


• Revenue Based Financing

• Invoice/Receivables Financing

• Equipment Financing

• Business Term Loans

• Business Line of Credit

• SBA Loans
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