FX Financial Entertainment Technology Financing Manufacturer, Vendor or Sales Rep?
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Online Application

Your business must have been operating and under existing ownership for at least four years. Only businesses in the US are eligible to apply.

  Company Information
  Legal Name of Company DBA
  Street Address Federal Tax ID
    Years in Business
  City Nature of Business
  State Phone # - -
  Zip Fax # - -
  Business Structure Corporation Proprietorship Partnership
 

  Trade References
1) Name of References Contact Person or Account Number
  phone # - - Fax # - -
2) Name of References Contact Person or Account Number
  phone # - - Fax # - -
3) Name of References Contact Person or Account Number
  phone # - - Fax # - -
 

Bank References
Name of Primary Bank
phone # - -
Contact Person
Name of Second Bank
phone # - -
Contact Person

  Ownership Information
1) Name Company Title
  Street Address % ownership %
    City
      State
      Zip
2) Name Company Title
  Street Address % ownership %
    City
      State
      Zip
 

- Release / Authorization -

By submitting this application I hereby authorize FX Financial and its assigns to obtain business as well as personal information regarding my credit history via banks, credit reporting companies, and any other extenders of credit. If this application has been completed by someone other than the applicant/principal owner, such person has advised the applicant/principal owner of FX Financial's right to obtain business as well as personal information regarding credit history via banks, credit reporting companies, and any other extenders of credit.

You must check the following in order to continue:
Applicant / Principal has completed the application or Applicant has been advised of FX Financial's rights as outlined above.