Request a Quote – Working Capital, Line Of Credit, Equipment Financing & More!

Step 1 of 5 - Loan Request

Comments
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Loan Request
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Campaign
How much would you like to borrow?*
Purpose of funds?*
How will you use the funds?*
Use this space to describe the purpose of your loan to the best of your ability.
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When do you need the funds?
Contact information
First name*
Last Name*
Email*
Best Phone Number*
Estimated Gross Annual Revenue*
We use this to determine your overall business performance and
the minimum revenue required is $120,000.
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Best Phone number(old)
Removed this field as this is a text field not visible in Twilio. DO NOT MAKE THE FIELD VISIBLE
By submitting this request for information, I hereby agree to:
- I've reviewed and accepted American Direct Funding's Terms and Conditions and Privacy Policy.
- I agree to receive text messages or pre-recorded messages from American Direct Funding regarding announcements and company updates. Reply to any message with STOP at any time to stop receiving messages. The frequency of messages varies. Message and data rates may apply.
By clicking "Click for free quote" you agree to American Direct Funding Terms & Conditions.

Basic info.
Company Name*
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Doing Business as (DBA)
Business Address*
Street City State Zip
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Business Address
12/19/2022 No longer in use as new Address field with Places API is being used
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Business City
12/19/2022 No longer in use as new Address field with Places API is being used
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Business State
12/19/2022 No longer in use as new Address field with Places API is being used
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Business Zip
12/19/2022 No longer in use as new Address field with Places API is being used
This field is hidden when viewing the form
Business Website
Business Phone Number*
Industry
Industry (Other)
Verification
Business Tax ID
Can be found on the top right of your tax return.
Date Established*
MM slash DD slash YYYY
Entity type*
Home Based?

Owner Information
First name*
Last name*
Home Address*
Street City State ZIP code
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Home Address
12/19/2022 No longer in use as new Address field with Places API is being used
This field is hidden when viewing the form
Home City
12/19/2022 No longer in use as new Address field with Places API is being used
This field is hidden when viewing the form
Home State
12/19/2022 No longer in use as new Address field with Places API is being used
This field is hidden when viewing the form
Home Zip
12/19/2022 No longer in use as new Address field with Places API is being used
Ownership %*
Please enter a number less than or equal to 100.
If 50% ownership then please input 51% for processing purposes.
Social Security Number*
Birthdate*
MM slash DD slash YYYY
Additional owners
- Additional owners
Additional Owner Information
First name*
Last name*
Additional Owner's Home Address*
Street City State ZIP code
This field is hidden when viewing the form
Home Address
12/19/2022 No longer in use as new Address field with Places API is being used
This field is hidden when viewing the form
Home City
12/19/2022 No longer in use as new Address field with Places API is being used
This field is hidden when viewing the form
Home State
12/19/2022 No longer in use as new Address field with Places API is being used
This field is hidden when viewing the form
Home Zip
Phone
Cell Phone
Ownership %*
Please enter a number less than or equal to 100.
What is your personal credit score?*
Applying won't affect your personal credit.
Social Security Number*
Birthdate*
MM slash DD slash YYYY

Terms and Conditions
Full Name*
Date
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IP address
We need your bank statements

Connect to your online bank account for a fast and safe way to send your revenue history. Click on the Connect your bank account button below and press submit to proceed. We have a partnership with Mastercard to ensure a fast and secure turnaround time. Offers are completed within 4-6 hours on average. We do not store your banking credentials.
Bank Statement Upload*
- Connect your bank account
- Manual upload
Upload PDF versions of your bank statements from each of your business accounts.
Upload Your Bank Statements (this will allow for faster response)
Drop files here or

Max. file size: 512 MB.
We need statements from your business checking account for the most recent 3 months (4 for California).
By signing below, each of the listed business and business owners/officers (individually and collectively, "you") authorize American Direct Funding ("ADF") and each of its representatives, successors, assigns and designees ("Recipients") that may be involved with or acquire commercial loans having daily weekly or monthly repayment features or purchases of the future receivables, including without limitation the application therefore (collectively, "Transactions") to obtain consumer or personal, business and investigative reports and others information about you, including credit card processor statements and bank statements, from one or more consumer reporting agencies, such as Transunion, Experian and Equifax, and from other credit bureaus, banks, creditors and other third parties. You also authorize ADF to transmit this application form, along with any of the foregoing information obtained in connection with this application, to any or all of the Recipients for the foregoing purposes, You also consent to the release, by any creditor or financial institution, of any information relating to any of you, to ADF and to each of the Recipients,on its own behalf. Each Applicant represents they are authorized to sign this application and agrees to do business with ADF electronically,and that electronic signatures on this application and any other documents to have the same legal effect as if Applicant has signed in ink. Applicant authorizes ADF and its effort to contact you using any of the telephone numbers and/or email addresses listed on this credit application or that you subsequently provide us in connection with you account.

Step 1 of 5 - Loan Request

Loan Request

Basic info.

Owner Information

Financial snapshot

Terms and Conditions

We need your bank statements

About American Direct Funding

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