Funding Application - TALAP Capital BDC

Name

First

Last

Business Name

DBA (if applicable)

Doing Business As

Business Email

Business Phone Number

Business Website

Multiple Choice

Legal Entity Structure

State Entity is Registered

Average Monthly Revenue

Desired Funding Amount

Purpose of Funding

Most Recent FICO Score

Date of Most Recent FICO Score

Desired of of

Total Credit Lines Open

Any Defaults in the Past?

Ownership of the Business

Industry Type

Consent

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