OCTIS FINANCE

Business Funding Application

Complete the application below. Required fields are marked with an asterisk (*).

Application support submission.octisfinance@yahoo.com · info.octisfinance@yahoo.com

FUNDING

Funding Overview

Annual Business Revenue * Average Bank Balance * Monthly Credit Card Volume * Financing Amount Requested *

BUSINESS

Primary Owner

First Name * Last Name * Email * Home Phone * Cell Phone * SS Number * Date of Birth * Annual Income * Credit Score * Ownership % * Home Address * City * State * ZIP *

OWNER

Secondary Owner

Is there a secondary owner? Yes No

DOCUMENTS

Four Months of Bank Statements

Drop all four of your most recent business bank statement PDFs into the box below. You can add them together in one place.

↑ Drop up to 4 PDF bank statements here or click to choose files

PDF files only. Maximum 4 statements. Do not upload passwords or bank login credentials.

AUTHORIZATION

Authorization & Submission

By submitting this application, I certify that the information provided is accurate and complete to the best of my knowledge. I authorize Octis Finance and its authorized funding partners to review the information provided for the purpose of evaluating the business funding request and to contact me regarding the application.