iPayment, Inc.

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iPAYMENT CASH PROGRAM

PARTNER

Business Cash Advance
$3,000 to $300,000 per location
APPLY NOW

Reward yourself today by taking advantage of one of your most valuable assets... YOUR CUSTOMERS. To get started simply provide the information requested below.

PROGRAM QUALIFICATIONS:
Must own business at least 9 months $4,000 minimum in credit cards sales per month In good standing with landlord with 1+ year lease	$10,000 minimum in gross sales per month Most business types accepted
FEATURES:
Decision in as little as 24 hours 97% Approval rate Free consultation	Cash in 7-10 days No up-front fees or closing costs Available in all 50 states
SUGGESTED BUSINESS CASH ADVANCE USES:
Cash Flow Equipment Taxes Advertising & Marketing	Expansion Unexpected Bills Inventory Any Business Desire!
BENEFITS:
No set term Not a loan	Easy payback process Builds business credit

FAXABLE APPLICATION
Our fax number is: 866-411-0315 or 866-311-8838 Attention: Marketing

* = Required

Corporate Name:

DBA if different:

Contact Person:

Daytime Phone:

* Ext:

Address:

Cell Phone:

City:

Fax:

State:

Zip:

Please provide us with your correct email address, you will be receiving
your application confirmation as well as additional information.

Email Address:

Email Address verification:

Website URL:

How did you hear about us?

Does your business presently accept credit cards?

Visa MasterCard None *

Amount of cash requested:

Monthly Visa/MasterCard Volume:

Total Monthly Sales:

Products/Services Sold:

Date your business was established:

Legal Entity:

* *

Intended use of funds:

State of Incorporation:

Choose your Industry Category:

Referring Agent:

Marital Status:

Business Category:

Lead Provider Comments:

Agreement - I, or an agent with my permission, completed this application and certify all information is true and accurate. I agree all documents furnished to Business Financial Services, Inc, (BFS), belong to them except as otherwise prohibited by applicable law and authorize BFS & its Merchant Account Processors or assigns, to access my credit report, Dunn & Bradstreet and other Financial Resources to verify any information or apply for credit on my behalf, electronically or otherwise.

Signature of Participant or Authorized Agent
(Type in your name to agree to the terms of the agreement)

Please print a copy of this page for your record.
If your app is not accepted properly please print this page & fax it to 866-411-0315.

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