Apply Now For Funding
Simply fill out the short questionnaire below, and submit.

There is no cost, and no obligation.

Within days, you can have access to up to $250,000 of working capital.

More than three-quarters of our clients are approved.

More than half are so happy, they apply for additional capital at a later date.

Invest in your future. And we will too.

If you believe that you are poised to grow, here is an unbeatable opportunity to get there faster. If you trust your potential, Merchant Cash & Capital will fund it.

Fill in the spaces below and click on "Submit." By doing so, you give Merchant Cash & Capital as well as its agents and affiliates, have permission to review the credit information in order to provide you with formal funding approval.

Business Information
Referred By:
Business Legal Name:	Business DBA Name:
Address:	Suite/Floor:
City:	State: None AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY
Zip:	Phone:
Mobile:	Fax:
Website :	Email :
Legal Entity: None Corp Sole Prop LLC Partnership	Type of Business: None Retail Restaurant Service Other
Federal Tax ID:	Landlord/Mortgage Company: Rent/Morgage Payment: Landlord Contact Name: Landlord Contact Phone: Landlord Contact Fax:
Owner/Principle Information
Name :	Title:
Address :	City:
State: None AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY	Zip:
Phone:	Fax:
Email :	Mobile:
%of Ownership:	SSN#:
Funding Information
Average Visa/Mastercard Monthly Sales: Average Monthly Sales:	Have you used a cash advance plan before?: NO Yes Enter the amount requested:
Average Ticket Size:	Type of Products Sold: