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Apply for a Business Loan

General Information

General Information Continued

Loan Request Information

Borrower Information

Revenue Gross: $

Business Information

Applicant Information

Applicant Information Cont.


Co-Applicant Continued

Banking Information #1

Banking Information #2

Real Estate Owned

Landlord Information

Business Equipment

Do you Plan to purchase Equipment?

Receivables & Purchases

Have you received PO financing previously?

Merchant Account

Merchant Information

Do you have any existing 'cash advances' and/or bank statement loans?

Trade Reference(s)

Trade Reference #2

Trade Reference #3

Credit Evaluation

Do you know your personal credit score?
Do you know if you have a D&B Business Credit File?

Do you have any UCC Lien Filings?

Do you have any existing Credit Lines?

Miscellaneous Information

Do you have any Federal & State Taxes past due?
Are you currently under the protection of the United States Bankruptcy Laws?

Have you been turned down previously? (This information is critical in determining what issues that need to be overcome)

Are you currently working with any lender, consultant or broker on this transaction?


I/We completed an application containing various information and certify that all of the information is true and complete. I authorize the lender to investigate my credit worthiness and verify any information provided on my/our application and other related documents.

Authorization To Obtain Credit Information

I / We represent and warrant that the information provided in this credit application is complete, accurate and true. Each individual signing below also requests and authorizes any lenders or funding source which may be utilized (collectively referred to as “Lenders”) to obtain information from the references listed above and obtain commercial and/or consumer credit histories that will be ongoing and relate not only to the evaluation of the business credit requested, but also for purposes of reviewing the account, increasing the credit line on the account (if applicable), taking collection action on the account, and for any other legitimate purpose associated with the account as may be needed.
A facsimile, electronic or other copy of this signed authorization shall be as valid as the original.

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