1. "We make you feel like family.”
Who we are.
We are a private equity firm comprised of financial
industry veterans and successful business owners. We
have been in business since 2009 and have provided
over $140 million in business financing. We have
successfully funded over 2000 business just like yours.
Most importantly, our customers love us. More than 60%
of our customers come back for more financing.
What we do.
We provide financing for all types of business'. Since we
are a private equity firm, and not a bank, we can offer
financing when banks cannot. Whether you are trying to
grow, expand, or just need a little extra working capital,
we offer many different options to get your business the
money you need. Our repayment plans are flexible and
have your business’ operating needs in mind.
Why us?
We pride ourselves on our ability to exceed customer
expectations. Our funding is quick and painless. In most
cases the money you need will be in your account in as
little as 48 hours. Here’s more on what makes us so great:
Industries We Fund:
• Automotive
• Beauty
• Construction
• Dental
• Restaurant
• Medical
• Shipping/Trucking
• Pharmacy
• Retail
• Manufacturing
• Hospitality/Hotel
• Beer/Liquor/Wine
• Healthcare
• and many more!
Traditional Bank Loan
• Up to 25 hours of paperwork
• Excellent credit required
• Collateral requirements
• Personal guarantees required
• Long wait times
• Require year round cash flow
• Lots of red tape and hassle
VS.
Merchant Cash Advance
• Single page application
• No credit requirements
• No collateral requirements
• No personal guarantees
• Funds in as little as 48 hours
• Seasonal cash flow is OK
• No hassles, no fine print
Don’t delay! Contact us today to see how much
you qualify for. (866) 866-0378
Funding Merchant Source, LLC
111 N Sepulveda Dr. #305
Manhattan Beach, CA 90266
www.fundingmerchantsource.com

2. Direct Phone # (516) 726-1729 Fax # (888) 892-1007
Email: jphifer@fundingmerchantsource.com
NEW APPLICATION CHECK LIST
PLEASE PROVIDE
 6 Months Business Bank Statements
-Please include most recent months and a month to date of current bank activity
-Please DO NOT SEND PERSONAL ACCOUNTS
-Please include all page of the bank statements
-Additional statements could be requested upon further review of file
 4 Merchant Account Statements
 12 Months Business Bank Statements (If a seasonal business)
 Completed application (Cannot be signed electronically)
*TO CUSTOMER:
- ALL STATEMENTS MUST INCLUDE EVERY PAGE (FRONT & BACK) even if there is no
information on it.
- Make sure to check off each item you have sent back.
** NO DEAL WILL BE ACCEPTED OR PROCESSED WITHOUT THIS COVER SHEET** We
guarantee a 24 hour response rate to our customers once a complete
package is received!
Representative Name: Jeff Phifer

3. Pre-Qualification Form
Business Legal Name: Business DBA Name:
Type of Business
Entity (Check One)
 Corporation
 Partnership
 Limited Liability Company
 Limited Liability Partnership
 Sole Proprietor
 Limited Partnership
Does the Merchant have any other open
contracts for working capital?
 Yes
 No
State of Incorporation: Use of Proceeds:
Physical Street Address: City: State: Zip:
Billing Street Address (if different thanabove):
City: State: Zip:
Physical Location Phone #: Billing Location Phone #: Preferred Contact Phone Number:
Industry Type (SIC Code or
Description)
O Rented O Mortgage
Amount: $
Current Credit Card Processor:
Gross Annual Sales:
(Previous year’s tax return):
Business Start Date:
(under current ownership):
Average Monthly
Credit Card Volume:
Lists the total
VISA/MasterCard processing
volumes from previous four
months:
Last Month
$
# of Tickets
Two Months Ago
$
# of Tickets
Three Months Ago
$
# of Tickets
Four Months Ago
$
# of Tickets
Principal/Owner
1
%
Ownership:
Primary Contact: Official Title:
Legal Last Name: Legal First Name: SSN: Date of Birth: Home Phone:
Home Address: City: State: Zip:  Own
 Rent
Principal/Owner
2
%
Ownership:
Primary Contact: Official Title:
Legal Last Name: Legal First Name: SSN: Date of Birth: Home Phone:
Home Address: City: State: Zip:  Own
 Rent
Authorizations
The Merchant and Owner(s)/Officer(s) identified above (individually, an "Applicant") each represents, acknowledges and agrees that (1) all information and documents provided to Funding Merchant Source, LLC ("FMS")
including credit card processor statements are true, accurate and complete, (2) Applicant will immediately notify FMS of any change in such information or financial condition, (3) Applicant authorizes FMS to disclose all
information and documents that FMS may obtain including credit reports to other persons or entities (collectively, "Assignees") that may be involved with or acquire commercial loans having daily repayment features or
purchases of future receivables including Merchant Cash Advance transactions, including without limitation the application therefore (collectively, "Transactions") and each Assignee is authorized to use such information
and documents, and share such information and documents with other Assignees, in connection with potential Transactions, (4) each Assignee will rely upon the accuracy and completeness of such information and
documents, (5) FMS, assignees, and each of their representatives, successors, assigns and designees (collectively, "Recipients") are authorized to request and receive any investigative reports, credit reports, statements
from creditors or financial institutions, verification of information, or any other information that a Recipient deems necessary, (6) Applicant waives and releases any claims against Recipients and any information-providers
arising from any act or omission relating to the requesting, receiving or release of information, and (7) each Owner/Officer represents that he or she is authorized to sign this form on behalf of Merchant.
Trade References #1: Contact Phone #:
Trade References #2: Contact Phone #:
Trade References #3: Contact Phone #:
Current Advance/Loan Balance $ Name of Financing Company:
Cell #: Fax #: Email:
Website: Landlord/Mtg Name: Landlord/Mtg Contact #:
Business Federal Tax ID #: Amount Requested:
For FMS Use only:
Agent Name: Jeff Phifer
Contact #: 516-726-1729
Fax #: 888-892-1007
Principal 1 Print Name: Principal 1 Signature: Date:
Principal 2 Print Name: Principal 2 Signature: Date:
Pre-Qualification Form
Business Legal Name: Business DBA Name:
Type of Business
Entity (Check One)
 Corporation
 Partnership
 Limited Liability Company
 Limited Liability Partnership
 Sole Proprietor
 Limited Partnership
Does the Merchant have any other open
contracts for working capital?
 Yes
 No
State of Incorporation: Use of Proceeds:
Physical Street Address: City: State: Zip:
Billing Street Address (if different thanabove):
City: State: Zip:
Physical Location Phone #: Billing Location Phone #: Preferred Contact Phone Number:
Industry Type (SIC Code or
Description)
O Rented O Mortgage
Amount: $
Current Credit Card Processor:
Gross Annual Sales:
(Previous year’s tax return):
Business Start Date:
(under current ownership):
Average Monthly
Credit Card Volume:
Lists the total
VISA/MasterCard processing
volumes from previous four
months:
Last Month
$
# of Tickets
Two Months Ago
$
# of Tickets
Three Months Ago
$
# of Tickets
Four Months Ago
$
# of Tickets
Principal/Owner
1
%
Ownership:
Primary Contact: Official Title:
Legal Last Name: Legal First Name: SSN: Date of Birth: Home Phone:
Home Address: City: State: Zip:  Own
 Rent
Principal/Owner
2
%
Ownership:
Primary Contact: Official Title:
Legal Last Name: Legal First Name: SSN: Date of Birth: Home Phone:
Home Address: City: State: Zip:  Own
 Rent
Authorizations
The Merchant and Owner(s)/Officer(s) identified above (individually, an "Applicant") each represents, acknowledges and agrees that (1) all information and documents provided to Funding Merchant Source, LLC ("FMS")
including credit card processor statements are true, accurate and complete, (2) Applicant will immediately notify FMS of any change in such information or financial condition, (3) Applicant authorizes FMS to disclose all
information and documents that FMS may obtain including credit reports to other persons or entities (collectively, "Assignees") that may be involved with or acquire commercial loans having daily repayment features or
purchases of future receivables including Merchant Cash Advance transactions, including without limitation the application therefore (collectively, "Transactions") and each Assignee is authorized to use such information
and documents, and share such information and documents with other Assignees, in connection with potential Transactions, (4) each Assignee will rely upon the accuracy and completeness of such information and
documents, (5) FMS, assignees, and each of their representatives, successors, assigns and designees (collectively, "Recipients") are authorized to request and receive any investigative reports, credit reports, statements
from creditors or financial institutions, verification of information, or any other information that a Recipient deems necessary, (6) Applicant waives and releases any claims against Recipients and any information-providers
arising from any act or omission relating to the requesting, receiving or release of information, and (7) each Owner/Officer represents that he or she is authorized to sign this form on behalf of Merchant.
Trade References #1: Contact Phone #:
Trade References #2: Contact Phone #:
Trade References #3: Contact Phone #:
Current Advance/Loan Balance $ Name of Financing Company:
Cell #: Fax #: Email:
Website: Landlord/Mtg Name: Landlord/Mtg Contact #:
Business Federal Tax ID #: Amount Requested:
For FMS Use only:
Agent Name: Jeff Phifer
Contact #: 516-726-1729
Fax #: 888-892-1007
Principal 1 Print Name: Principal 1 Signature: Date:
Principal 2 Print Name: Principal 2 Signature: Date:
Pre-Qualification Form
Business Legal Name: Business DBA Name:
Type of Business
Entity (Check One)
 Corporation
 Partnership
 Limited Liability Company
 Limited Liability Partnership
 Sole Proprietor
 Limited Partnership
Does the Merchant have any other open
contracts for working capital?
 Yes
 No
State of Incorporation: Use of Proceeds:
Physical Street Address: City: State: Zip:
Billing Street Address (if different thanabove):
City: State: Zip:
Physical Location Phone #: Billing Location Phone #: Preferred Contact Phone Number:
Industry Type (SIC Code or
Description)
O Rented O Mortgage
Amount: $
Current Credit Card Processor:
Gross Annual Sales:
(Previous year’s tax return):
Business Start Date:
(under current ownership):
Average Monthly
Credit Card Volume:
Lists the total
VISA/MasterCard processing
volumes from previous four
months:
Last Month
$
# of Tickets
Two Months Ago
$
# of Tickets
Three Months Ago
$
# of Tickets
Four Months Ago
$
# of Tickets
Principal/Owner
1
%
Ownership:
Primary Contact: Official Title:
Legal Last Name: Legal First Name: SSN: Date of Birth: Home Phone:
Home Address: City: State: Zip:  Own
 Rent
Principal/Owner
2
%
Ownership:
Primary Contact: Official Title:
Legal Last Name: Legal First Name: SSN: Date of Birth: Home Phone:
Home Address: City: State: Zip:  Own
 Rent
Authorizations
The Merchant and Owner(s)/Officer(s) identified above (individually, an "Applicant") each represents, acknowledges and agrees that (1) all information and documents provided to Funding Merchant Source, LLC ("FMS")
including credit card processor statements are true, accurate and complete, (2) Applicant will immediately notify FMS of any change in such information or financial condition, (3) Applicant authorizes FMS to disclose all
information and documents that FMS may obtain including credit reports to other persons or entities (collectively, "Assignees") that may be involved with or acquire commercial loans having daily repayment features or
purchases of future receivables including Merchant Cash Advance transactions, including without limitation the application therefore (collectively, "Transactions") and each Assignee is authorized to use such information
and documents, and share such information and documents with other Assignees, in connection with potential Transactions, (4) each Assignee will rely upon the accuracy and completeness of such information and
documents, (5) FMS, assignees, and each of their representatives, successors, assigns and designees (collectively, "Recipients") are authorized to request and receive any investigative reports, credit reports, statements
from creditors or financial institutions, verification of information, or any other information that a Recipient deems necessary, (6) Applicant waives and releases any claims against Recipients and any information-providers
arising from any act or omission relating to the requesting, receiving or release of information, and (7) each Owner/Officer represents that he or she is authorized to sign this form on behalf of Merchant.
Trade References #1: Contact Phone #:
Trade References #2: Contact Phone #:
Trade References #3: Contact Phone #:
Current Advance/Loan Balance $ Name of Financing Company:
Cell #: Fax #: Email:
Website: Landlord/Mtg Name: Landlord/Mtg Contact #:
Business Federal Tax ID #: Amount Requested:
For FMS Use only:
Agent Name: Jeff Phifer
Contact #: 516-726-1729
Fax #: 888-892-1007
Principal 1 Print Name: Principal 1 Signature: Date:
Principal 2 Print Name: Principal 2 Signature: Date: