TPG Business Financing Application Company Information Legal Company Name State of Incorporation Federal Tax ID Legal Entity TypeLegal Entity TypeLLCLLPCorporationGeneral PartnershipNon-Profit Physical Address Company Type / Industry City State Zip Code Do you rent or own location?Do you rent or own location?RentOwnNot applicable (Mobile / Remote) Business Inception Date Do you have outstanding business loans?Do you have outstanding business loans?YesNo Total Outstanding Loan Balance (if applicable): Does your business have a separate bank account?Does your business have a separate bank account?YesNo Has your business accepted credit cards for at least 3 months?Has your business accepted credit cards for at least 3 months?YesNo Business Financial Overview Your Annual Business Revenue (Gross) Your Average Bank Balance (Combined) Your Average Monthly Revenue (Gross) Financing Amount Required (Total) Primary Customer Payment MethodPrimary Customer Payment MethodCredit / Debit CardsACH / Bank TransferInvoice / Accounts ReceivableCash / CheckE-Commerce / Online PaymentsOther / Mixed Funding Needs What is the primary purpose of the funding?What is the primary purpose of the funding?Working Capital / Cash FlowEquipment / Vehicles / TechnologyInventory / MaterialsPayroll / StaffingTax Obligations / Business LiabilitiesStart a businessBuy a business / Partner BuyoutBridge / Interim FinancingGovernment Contract FinancingMarketing / Sales / Customer AcquisitionExpansion / New LocationRenovation / Build-OutCommercial Real EstateResidential Real Estate InvestorBusiness AcquisitionRefinance / Consolidate Debt (Includes Personal Business Debt)Accounts Receivable / Invoice FinancingPurchase Orders / Contract FulfillmentProject / Contract MobilizationGrowth / Strategic InvestmentEmergency / Short-Term Business NeedsOther What else would you use the funding for? (Optional)What else would you use the funding for? (Optional)Working Capital / Cash FlowEquipment / Vehicles / TechnologyInventory / MaterialsPayroll / StaffingTax Obligations / Business LiabilitiesStart a businessBuy a business / Partner BuyoutBridge / Interim FinancingGovernment Contract FinancingMarketing / Sales / Customer AcquisitionExpansion / New LocationRenovation / Build-OutCommercial Real EstateResidential Real Estate InvestorBusiness AcquisitionRefinance / Consolidate Debt (Includes Personal Business Debt)Accounts Receivable / Invoice FinancingPurchase Orders / Contract FulfillmentProject / Contract MobilizationGrowth / Strategic InvestmentEmergency / Short-Term Business NeedsOther Any additional use of funds? (Optional)Any additional use of funds? (Optional)Working Capital / Cash FlowEquipment / Vehicles / TechnologyInventory / MaterialsPayroll / StaffingTax Obligations / Business LiabilitiesStart a businessBuy a business / Partner BuyoutBridge / Interim FinancingGovernment Contract FinancingMarketing / Sales / Customer AcquisitionExpansion / New LocationRenovation / Build-OutCommercial Real EstateResidential Real Estate InvestorBusiness AcquisitionRefinance / Consolidate Debt (Includes Personal Business Debt)Accounts Receivable / Invoice FinancingPurchase Orders / Contract FulfillmentProject / Contract MobilizationGrowth / Strategic InvestmentEmergency / Short-Term Business NeedsOther Business Needs What else could help your business?What else could help your business?Payments & Merchant ServicesManaged IT & CybersecurityCommunications & ConnectivitySoftware, Data & AITechnology Integration & AutomationWorkforce Development & TrainingRecruiting & StaffingBusiness Operations & Process ImprovementSales & Business DevelopmentMarket & Opportunity IntelligenceProfessional & Advisory ServicesStrategic PartnershipsOtherNot Sure / Let’s DiscussNothing Else Right NowTariff Cost Recovery / Refunds What is the biggest challenge facing your business right now?What is the biggest challenge facing your business right now?Cash Flow / Access to CapitalIncreasing Revenue / Finding CustomersTechnology / ITCybersecurity / RiskStaffing / WorkforceOperational EfficiencyExpansion / ScalingMarket Access / New OpportunitiesContracts / Government BusinessBusiness Strategy / PlanningOther / Not Sure Owner Information 1 First Name Last Name Email Phone Home Address (no PO Boxes) City State Zip Code Your Business Ownership % Does any other individual or entity have ownership interest in the business?Does any other individual or entity have ownership interest in the business?YesNo Preferred Contact MethodPreferred Contact MethodEmailPhoneEither Owner Information 2 Complete this section for any additional individual with an ownership interest in the business. First Name Last Name Email Phone Home Address (no PO Boxes) City State Zip Code Business Ownership % Preferred Contact MethodPreferred Contact MethodEmailPhoneEither Additional identity, credit, financial, and supporting information may be requested after initial review. Additional Information Additional Notes By signing this application, I certify that I am authorized to provide information on behalf of the business identified above and that the information provided is true and complete to the best of my knowledge. I authorize The Powers Group, LLC (“TPG”) to use the information provided to evaluate the requested financing requirement, identify potential financing options, and communicate with me regarding this request. I authorize TPG to share this application and related information with prospective financing providers, partners, and service providers as reasonably necessary to evaluate, structure, or fulfill the requested financing. I understand that submission of this application does not constitute an offer, approval, or commitment to provide financing and that additional information, documentation, authorizations, or provider-specific applications may be required before financing can be offered or approved. I understand that TPG will not obtain a personal credit report based solely on this application unless I separately provide any authorization required for such inquiry. I certify that I am authorized to submit this application and agree to the certification and authorization above. I certify that I am authorized to submit this application and agree to the certification and authorization above.I am authorized We only use your information to support your request. We don’t like spam either. SUBMIT APPLICATION
