Application

BUSINESS TRADE REFERENCES
(Please list at least 3 trade suppliers. Please attach any additional references on a separate page.)
Business Name:
Contact, Account # or Fax #:
Phone #:
Business Name:
Contact, Account # or Fax #:
Phone #:
Business Name:
Contact, Account # or Fax #:
Phone #:

OTHER INFORMATION
Credit Card Processing Terminal(s)/Software Model:
Number of Terminals:
Avg. Monthly Credit Card Volume
Avg. Monthly Gross Sales Volume
Requested Advance Amount:
Do you Accept:
- Visa/MasterCard
- Amex
- Discover
- Debit
- EBT
Please check all that apply.
Prior/Current Cash Advance Company (if applicable):
Balance:
*
- Applicant(s) authorizes My Rainy-Day Company and its assigns, agents, banks or financial institutions to obtain an investigative or consumer report from a credit bureau or a credit agency and to investigate the references given on any other statement or data obtained from applicant.

BUSINESS INFORMATION