Business Funding Application

Complete, sign, and submit

Complete all sections below, upload your bank statements, sign, and submit.

Secure & encrypted upload

Business Information

Tell us about your business.

Legal Business Name *

DBA (if different)

Business Address *

City *

State *

ZIP *

Business Phone *

Business Email *

Website

Industry *

Entity Type *

Federal Tax ID / EIN *

Date Business Started *

Owner Information

Primary owner / officer information.

Owner Full Name *

Ownership % *

Cell Phone *

Email *

Home Address *

Date of Birth *

SSN *

Sensitive info is encrypted in transit and never displayed in the application PDF in full.

Funding Request

How much funding do you need and what for?

Requested Funding Amount *

Average Monthly Revenue *

Current Funding Positions / Advances

Preferred Contact Method

Upload Documents

Optional — uploading bank statements speeds up your approval.

Bank Statements (optional)

Last 4 months + month-to-date recommended · PDF/JPG/PNG · 15MB each

0 uploaded

Click to upload

PDF, JPG, or PNG · up to 15MB each

Optional Documents (recommended for faster approval)

Driver's License

Upload Driver's License

Voided Check

Upload Voided Check

Required Signature

Review the authorization, sign, and submit.

Authorization

I certify that the information provided is true and accurate. I authorize Ai Funding Group and its funding partners to review my business, bank statements, credit profile, and supporting documents for funding approval.

I have read and agree to the authorization above.

SMS TFN Verification & Consent Form

By entering your phone number, you agree to receive Marketing text messages from Ai Funding Group. By submitting this form, I consent to receive Marketing SMS messages from Ai Funding Group. I understand that message & data rates may apply and that I can opt out anytime by replying STOP.

I agree to receive SMS messages from Ai Funding Group. *I consent to receive Marketing emails from Ai Funding Group. I can unsubscribe at any time using the link in any email.

Message frequency may vary. Message & data rates may apply. Reply STOP to opt out or HELP for help. Consent is not a condition of any purchase or funding approval.

Type your full legal name *

Draw your signature *

Draw your signature above using your mouse or finger

Audit trail: When you submit, we record the exact time, your IP address, browser/device, and a unique audit ID. These are embedded into the signed record.