Tel: 281-453-1556 Fax: 713-800-4121 Email: belmontbusinessloans@gmail.com
Corp Sole Prop LLC Partnership Other
Retail Restaurant Service Internet
Store Front Office Home Other
Owner# 1/Principal Information
Owner# 2/Principal Information
Landlord Contact Information
Landlord/Mortgage Company
Landlord/Mortgage Company Contact
By signing below, the Merchant and its Owners / Principals: (1) certify that all information and documents submitted in connection with this
application is true, correct and complete; (2) authorize The Belmont Franklin Group its agents, partners, and lenders, to receive credit
reports and any other information regarding the Merchant and its Owners and Principals from third parties, to verify any information
provided on the application ; (3) to receive an occasional promotion or offer by email or fax.
By By ______________________________________
Date Date
MERCHANT APPLICATION
Step 1: Complete Application
Step 2: Download your last 3 Months Bank Statements
Step 3: Scan your Drivers License and a Voided Check
FINAL - Step 4: Return all the above via email or fax for an Approval!