Verified Financial Portal

Bright Beginnings Financial Services

256-Bit SSL Encrypted Intake

Funding Prequalifier

PLEASE COMPLETE THE FORM IN IT'S ENTIRETY. IF A QUESTION IS NOT APPLICABLE, PLEASE PUT "N/A"

1

Personal Demographics & Contact

Legal identification and residence information

Name *

First Name

Last Name

Suffix

Mailing Address *

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Physical Address *

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Phone Number *

Please enter a valid phone number.

Email *

Provide proof of address *

Browse Files

Drag and drop files here

PDF, PNG, JPG up to 10MB

Date of Birth (MM/DD/YYYY) *

SSN *

Encrypted with bank-grade security.

2

Funding Scope & Status

Target funding type, registration and business phone

Which funding are you interested in? *

Personal

Business

Personal & Business

Is your business registered and up to date? *

Yes

No

Is your business registered with home or business address? *

Home

Business

Do you have a business phone number separate from your personal phone number?

Yes

No

Do you have a Dun & Bradstreet number *

Yes

No

Where is your business registered? *

3

Provider & Investment Parameters

Select professional provider and financing arrangements

Choose your provider *

Provide name of who referred you *

If financing is needed, which do you prefer? *

Klarna

Afterpay

Affirm

Are you ready to make the investment today? *

Yes

No

Amount of funding needed *

Are you an expedited client? *

Yes

No

Credit Scores Profile *

What is your Equifax FICO score? *

What is your Transunion FICO score? *

What is your Experian FICO score? *

4

Business Entity & Official Documentation

Entity identity, EIN, and official incorporation records

Business Name (exactly how it is on EIN and articles of incorporation)

Business Address

Provide proof of business address

Browse Files

Drag and drop files here

PDF, PNG, JPG up to 10MB

Provide Articles of Incorporation

Browse Files

Drag and drop files here

PDF, PNG, JPG up to 10MB

Business Phone Number

Business Email Address

Total Gross Annual Income

EIN

Provide EIN letter

Browse Files

Drag and drop files here

PDF, PNG, JPG up to 10MB

Length of time in business

NAICS Code

Type of business

5

Authorized Users, Trade Lines & Security

Current credit footprint and authorization settings

Would you like to add an authorized user? *

Yes

No

Balance Transfer *

Yes

No

Mother's Maiden Name *

List all credit cards that you currently have *

Desired Business name on card

Does your business use another name as in trade or dba?

Yes

No

Is your business address the same as your personal address?

Yes

No

Number of Employees

Business Establish Date (MM/DD/YYYY)

6

Revenue & Financial Operations

Classification, cash flow metrics, and communication setup

Annual Business Revenue

Business Category

Business Type

Business Subtype

Estimated Monthly Spending

Would you like to add any employee cards?

Yes

No

Would you like to go paperless? *

Yes

No

7

Disclosures & Authorizations

Compliance consents, advisory call schedule, and identity checks

Do you give me authorization to apply on your behalf? *

Yes

No

Do you need your personal credit fixed? *

Yes

No

Do you need to build business credit? *

Yes

No

Do you have life insurance? *

Yes

No

Do you understand that once you have received funds, you will not attempt to do a charge back? All Sales are Final *

Yes

No

Are you applying on behalf of yourself using your SSN or EIN assigned to you? *

Yes

No

Provide Driver's License *

Browse Files

Drag and drop files here

PDF, PNG, JPG up to 10MB

An advisor will call you, which time of day is best? *

8am-12pm EST

12pm-4pm EST

4pm-8pm EST

I verify that all information provided is accurate and true. *

Yes

No

I understand that all funding packages start at $1500 and up. Only submit this form if you are serious about obtaining funding to create wealth and changing your financial situation. We are serious and committed to helping individuals excel in life. *

Yes

No

8

Execution & Legal Signature

Digital signature pad and execution date

Signature *

Sign here with your mouse or finger

Date *

All submissions are encrypted with TLS 1.3 and transmitted via secure protocols.