Connect With a Business Express Lender Today!

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General Information

Loan Amount*

Note: Minimum loan amount is $10,000.

Are you currently a MidFirst Bank Customer?*

State*

Briefly describe what these funds will be used for (500 character max)*

Business Information

Years in Business*

Has the applicant(s) or any proposed guarantor(s) declared bankruptcy or had any judgements, repossessions or short sells, garnishments or other legal proceeding filed against them in the last seven years?*

Business has been profitable for the last two years?*

Legal name*

Street Address*

City*

Zip*

Business Primary Phone*

Business Created Date*

Business Ownership Date*

DBA Trade Name

Tax Filings*

Street Address 2

State*

Business Website

Industry*

Business Ownership Contact Information

Business Owner Personal Credit Score*

First Name*

Street Address*

City*

Zip*

Email*

Last Name*

Street Address 2

State

Ownership Percentage*

Verify Email*

Best phone # to reach you*

Are you a US Citizen or Resident?*

Is there anything else that you would like to share about your business and/or loan request?

Please press “submit” to connect with a local lender. We will reach out to you within 4 business hours to discuss your options.