Business Funding Application | I Revive Capital

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Business Information

Tell us about your business to get started.

Email Address

Legal Business Name

DBA

Business Address

Street Address

City

State

Zip Code

Business Phone

Date Business Started

Federal Tax ID (EIN)

State of Incorporation

Owner Information

Details about the primary business owner.

Full Name

Title

Home Address

Street Address

City

State

Zip Code

Ownership Details

Ownership %

Length of Ownership

Date of Birth

Social Security Number

Home Phone

Cell Phone

Second Owner

If applicable, provide details for the second owner.

ⓘ No second owner? You can skip this step entirely.

Full Name

Title

Length of Ownership

Home Address

Street Address

City

State

Zip Code

Ownership %

Date of Birth

Social Security Number

Home Phone

Cell Phone

Documents & Signature

Upload bank statements and sign to complete your application.

Bank Statement 1

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Choose a file or drag it here

PDF, JPG, PNG, DOC — max 10MB

Bank Statement 2

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Choose a file or drag it here

PDF, JPG, PNG, DOC — max 10MB

Bank Statement 3

📄

Choose a file or drag it here

PDF, JPG, PNG, DOC — max 10MB

Bank Statement 4

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Choose a file or drag it here

PDF, JPG, PNG, DOC — max 10MB

Purchase Orders

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Choose a file or drag it here

PDF, JPG, PNG, DOC — max 10MB

Disclosure

By signing below, the Merchant and its owners/principals: (1) certify that all information and documents submitted in connection with this Application for the purchase of future receivables, including merchant cash advance transactions, are true, correct, and complete; and (2) authorize I Revive Capital LLC, its partners, funders, and lenders to obtain and receive credit reports and any other information regarding the Merchant and its owners and principals from third parties for the purpose of verifying the information provided in this Application.

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Applicant Signature

Application Received!

Thank you for submitting your business funding application. Our team will review your information and reach out to you shortly.