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Dear Client,

Please fully complete this application to the best of your ability. Answer all appropriate questions on this application even if it is a negative issue. You will want to let your new Funding Source know as much as possible. Our job is to help you get the cash you need. Any negative issues are not intended to disqualify you, but to allow us to confront these issues head on. So be accurate and truthful to the best of your knowledge. This is very important. You don't want to waste time, slow down your application, or not receive a quote at all!

Upon completion and submission of this form, you will receive an immediate email with your confirmation and funding source information. Please add “globalquickcapital.com” to your allowed email to ensure delivery.

Please note that these Applications are for conducting cash flow business or applying for loans only! These are not job applications!


Thank you,
GlobalQuick CAPITAL

Credit Card Sales Revenue Application

Requirements

  • Minimum: $5,000
  • Maximum: $150,000
  • Accepted Locations: USA Only
  • Adults 18 and over only

Contact


Contact First Name:

Contact Last Name:

Title:

Email Address:

Phone Number:

Fax Number:

Cell Number:

Company Information


Legal Company Name:

DBA name (if applicable):

Present Company Address


Address 1:

Address 2:

City:

County:

State:

ZIP Code:

Business description:

Website:

Does the company have any other business locations?
 Yes   No

If so, list addresses, phone and fax numbers:

Company Structure


Structure:
 Corporation
 Partnership
 Sole Proprietorship
 LLC

Date Established:
 

State of Incorporation:

Date of Incorporation:
 

Number of employees:

Sales


Total Monthly Sales:

Average Monthly
Visa/MasterCard
Sales:

Company Other


Has the business ever been involved in a Lawsuit?
 Yes   No

If so, please include an explanation:

Describe all current brokering and/or sales activities of the business:

Describe any other current activities of the business:

List the names of all companies with which the business has current brokering, agent and/or sales relationship:

List the names and dates of all companies with which the business had a previous brokering, agent and/or sales relationship:

Principals of Company

Principal 1


Principal 1 - Name:

Title:

Date of birth:
  

Address:

How long at this address?

Home Phone:

Percent Ownership:
 %

Years with Company:

Years in Industry:

Ever Declared Bankruptcy?
 Yes   No

If Yes, Year:

If Yes, City/State:

Ever Been Convicted of a Felony?
 Yes   No

If Yes, Year:

If Yes, City/State:

Principal 2


Principal 2 - Name:

Title:

Date of birth:
  

Address:

How long at this address?

Home Phone:

Percent Ownership:
 %

Years with Company:

Years in Industry:

Ever Declared Bankruptcy?
 Yes   No

If Yes, Year:

If Yes, City/State:

Ever Been Convicted of a Felony?
 Yes   No

If Yes, Year:

If Yes, City/State:

Principal 3


Principal 3 - Name:

Title:

Date of birth:
  

Address:

How long at this address?

Home Phone:

Percent Ownership:
 %

Years with Company:

Years in Industry:

Ever Declared Bankruptcy?
 Yes   No

If Yes, Year:

If Yes, City/State:

Ever Been Convicted of a Felony?
 Yes   No

If Yes, Year:

If Yes, City/State:

Principal 4


Principal 4 - Name:

Title:

Date of birth:
  

Address:

How long at this address?

Home Phone:

Percent Ownership:
 %

Years with Company:

Years in Industry:

Ever Declared Bankruptcy?
 Yes   No

If Yes, Year:

If Yes, City/State:

Ever Been Convicted of a Felony?
 Yes   No

If Yes, Year:

If Yes, City/State:

Client Information


What is your motivation?

How much cash do you need or want?

Date Needed:
 

Comments


Additional Comments:

How did you hear about GlobalQuick CAPITAL?

Who Referred You?


No one referred me:

Referred Name:

Referred Phone:

Referred Email:

Application Id:
20241121-004451-257

Please note:
The Funding Source may require copy of additional documents
to make your quote. They will let you know by Email.


Upon submission of this form, you will receive an immediate email with your confirmation and funding source information. Please add “globalquickcapital.com” to your allowed email to ensure delivery.


Privacy Policy & Security

Apply online for a free no obligation quote: Response in 24 to 48 hours in most cases. Our funding sources will be happy to answer all your questions at that time!

We are proud members of the cash flow/growing wealth industry.

We are a
green
company!

We at GlobalQuick CAPITAL believe in giving back to help in this world! A portion of the profits from our earnings will be given to: Heart Research, Arthritis Research, Endangered Animal Species, and Rain Forest Preservation.