Qualify with 4 simple YES's
	Business has accepted Credit Cards for at least 12 months
	Monthly Credit Card volume is 15+ transactions and $5,000+ in sales
	All prior bankruptcies (if any) have been resolved for 12+ months
	At least one (1) year remains on the current retail lease (if not owned)
Please take a few moments and tell us a little bit about your scenario: ( * denotes a REQUIRED field)
Broker Information
*	Company Name:
*	Email:
*	Broker/LO Name:
*	Broker Email:
*	Broker Phone:
Scenario Information
*	Merchant Name:
*	Merchant Email:
*	Approx. Merchant FICO:	Select One: Sub 500 501-550 551-600 601-650 651-700 701-750 750+ Not Sure
*	Company Name:
*	Property Address:
*	City:	ST: -- AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY  Zip:
*	Business Type:	Select One: Automotive Bar Nightclub Beauty-Nail Salon Communications Construction Distributor Dry Cleaner Entertainment Florist Furniture Gas Station Healthcare Import-Export Internet Only Manufacturer Real Estate Restaurant Retail Services Specialty Technology Transportation Wholesaler Other
	Other Description:
*	Property Ownership:	Select One: Owned Leased Not Sure
*	Time in Business:	Select One: 0 - 12 Months 12 - 24 Months 24 - 60 Months More than 5 Years
*	Average Monthly Credit Card Sales:
*	Gross Monthly Sales:
*	Advance Amount Desired:	Calculate MAX Amount Below
Other Information
	Notes:

** Please complete the REQUIRED fields **
Partial submissions cannot be evaluated and therefore may not receive a response