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Business Information
Federal Tax ID
*
Business Legal Name
*
Business DBA Name
Type of Business Entity
*
–
Corporation
Limited Liability Partnership
Limited Liability Company
Partnership
Sole Proprietorship
Limited Partnership
Primary Business Structure
*
–
Home-based Business
E-commerce
Franchise
None of the above
State of Incorporation
*
–
AL
AK
AZ
AR
CA
CO
CT
DC
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
Business Date under Current Ownership
*
MM slash DD slash YYYY
Physical Address
*
Street Address
City
AL
AK
AZ
AR
CA
CO
CT
DC
DE
DE
FL
GA
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
State
ZIP Code
Billing Address
*
Street Address
City
AL
AK
AZ
AR
CA
CO
CT
DC
DE
DE
FL
GA
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
State
ZIP Code
Business Owner Cell Phone
*
Business Owner Fax
Business Website Address
Industry Type
*
–
Abortion Clinics
Accountants/ CPA's
Accounting / Tax Prep.
Accounting firms
Adult Entertainment
Adult Entertainment – Examples: Online Dating, Speed dating
Adult Industry
Advertising & Marketing
Agriculture
Airline industry – anything related
Airlines
Amusement / recreation
Animal Hospital/ Veterinarian
Annual Memberships
Antiques / Collectibles
Apparel and Accessories
Appliance Sales
Architecture
Art Galleries
Artists
ATM Services
ATM Vendors
Attorney
Auction
Auction, Appraisal & exchange services
Auto dealers
Automotive
Automotive Customization
Automotive Repair
Auto – restoration
Auto sales (new or used)
Bail Bond Services
Bakery
Bank Lenders
Bar/Pub
Bar & Grill
Beauty Salon / Spa
Beauty Shops
Bed and Breakfasts
Bike Store
Bridal/ Wedding
Brokerage
Building Materials
Businesses in Miami/Dade County, FL
Business Services
Call Center
Cannabis Growers and Sellers
Cannabis – related
Car Services (Uber, Lyft, etc.)
Carwash
Casinos / Gambling
Catering
Celebrities
Cellular Store
Check Cashing
Chiropractor
Churches / Religious Organizations
Class 3 Weapons Dealers
Clothing Store
Clothing Wholesale
Coin dealers
Collection Agency
Commodity – based (precious metals)
Concierge Services (likely within sic code 4724)
Consignment
Construction
Consulting
Consumer Debt Counseling Services
Convenience Store
Convention Related Industries
credit repair
Crime Investigator
Crude petroleum and natural gas extraction
Cryptocurrency
Dating Services
Debt Collection
Dentist
Depository Credit Intermediation
Digital Advertising/Media Groups
Doctor
DOD / Military – Active
Drilling oil and gas wells
Drug paraphernalia
Dry Cleaning
Electronics
Employment agencies
Engineering/Design
Entertainment
Entertainment / circus
Environmental Services
Equipment Rentals
Equipment sales/rentals
Event Planners
Excavation work
Facilities Support Services
Farms / Livestock
Finance
Financial Advisers
Financial Institutions
Financial Services
Financial Transaction & Payment Processing
Firearms, Guns, & Ammunition manufacturer & sales
Firearms/Ammunitions
Firearms (gun) training / shooting range
Flea Markets
Flight Training
Flooring
Florist
Food & Beverage
Franchising
Freight Brokers/Logistics
Freight Transportation Arrangement
Funeral Homes
Furniture store/sales
Galleries
gambling
Gasoline stations with convenience stores
General Merchandise
Gift Shops
Gold Dealers
Golf
Grocery / Supermarket
Grocery and Baked Goods
Grocery Stores and Supermarkets
Guns
Gun Shop
Gun Shops
Gym
Hair salons
Healthcare
Health Services
Heating & Air Conditioning
Home Builders
Home Flipping
Home Furnishing
Home Health Care
Home Improvement
Hospices
Hospitality
Hotel, Motel, and Lodging
Import/Export
Influencers
Insurance Agents / Brokers, services
Insurance Carriers
Insurance – no home-based
Interior Design
Investigation and Security Services
Investment opportunities
Investors
Janitorial/Cleaning
Jewelry Store
Kiosks
Landscaping
Laundry and Garment Services
Law Firm
Lawn Mower Repair
Lead Generation
Learning Institutions
Legal Services
Lenders, Banks, & Credit Unions
Lending / Financing Firm (equipment financing)
Lending Services
Life Coaching
Limo Service
Limousine/Taxi Company
Liquor store
Livestock
Lobbiests
Lottery & Gaming
Lumber & Wood Products
Mailing/ Shipping
Manufacturing
Mattress Sales
Medical
Medical Billing
Medical Transportation/Ambulances
Mining, Quarrying, and Oil and Gas Extraction
Monetary Authorities-Central Bank
Money Services, Banks, Virtual Currency
Money Wiring
Mortgage Lenders
Motor Vehicle Dealers
Moving & Storage
Moving Company
Multi-level Marketing
Nail Salons
Naturopathic Medical Doctor
New Home Builders / kitchen, bath remodels
NFP – Advocacy / Lobbying
Nightclubs
Nondepository Credit Intermediation
Non Profit
Non-profit & Religious
Non-Profit Organizations
Non-profits – Axos states only
Nutritional products/ supplements
Office Administrative Services
Oil
Oil / Mining
Oil & Gas Exploration
Oil Drilling
Other Investment Pools and Funds
Outsourcing
Painters
Parking Garages
Passenger Transit / Transportation
Paving/ Sealing/ Concrete
Pawn Shop
Personal Services
Pest Control
Pet supplies
Pharmacy
Physical Fitness Facility
Places of Worship
Plumbing
Political Groups
Postal Service / The UPS Store
Precious Metals / Stones, Coin Sales, & Stamp Sales
Printing(have equipment)
Professional Services
Property Management Company
Publicly Traded Companies
Public Motivational Speakers / Seminars
Radio/Television
Real estate
Real Estate / Property Management
Real Estate Rentals and Leasing
Real Estate Sales
Recreation
Recruiting / Staffing
Religious
Religious Affiliations (Associated with the Church)
Repair Services (other)
Repossession Services
Residential Remodelers / Building Construction
Restaurant
Restaurant/Bar
Restaurant (Quick Service/Fast Food)
Retail Nursery
Retail Store (Retail)
Roofing Siding & Sheet Metal Work
Salon
Sanctioned Business (OFAC, SDN)
Schools (or related to, such as educational material)
Securities and Commodity Exchanges
Security Services
Shoe Stores
Software/Technology
Solar
Specialty Trade Contractors
Sporting Goods Stores
Staffing Service
Steakhouse
Subscription Boxes
Surrogacy (pregnancy)
Syndicating Partner
Tanning Salon
Taxi
Telecommunications
Ticket Brokers
Ticket Sales
Tire Shop
Tobacco/Smoke Shops
Towing
Toy Stores/Hobby Shops
Tradesworkers
Transmission shop
Transportation
Travel Agency
Trucking
Used technology equipment
Vacation Rentals
Vape Shops
Vending Machines
Veterinary Clinic
Waste Disposal/ Recycling / Trash Recycling
Waste Treatment
Wealth Management – no home-based
Weight Loss Management / Membership
wholesale
Wholesale Beer & Beverage
Wholesale Electronics
Wholesale Food Distributors
Wireless (cell phone) Store
Women's clothing stores
Electrician Electric
General Contractors/Specialty Contractors
Personal Information
Primary Owner
*
First
Last
Social Security Number
*
Date of Birth
*
MM slash DD slash YYYY
Home Phone
*
Home Address
*
Street Address
City
AL
AK
AZ
AR
CA
CO
CT
DC
DE
DE
FL
GA
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
State
ZIP Code
Job Title
*
Landlord Name
Landlord Contact
Email
*
Ownership Percentage
*
Please enter a number from
1
to
100
.
Personal Information – Secondary Owner
Secondary Owner
First
Last
Date of Birth
MM slash DD slash YYYY
SSN
% Ownership
Please enter a number from
1
to
100
.
Home Address
Street Address
City
AL
AK
AZ
AR
CA
CO
CT
DC
DE
DE
FL
GA
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
State
ZIP Code
Cell Phone
Email
Funding Information
Use of Funds
*
–
Advertising
Buy a business
Debt consolidation
Equipment purchase
Equipment lease
Expansion
Inventory
Startup
Other
Payroll
Real Estate
Remodeling
Taxes
Working Capital
Do you currently have any Judgements/Liens?
*
–
Yes
No
Do you have any open bankruptcies?
*
–
Yes
No
Is your business seasonal?
*
–
Yes
No
Peak Months
*
Do you currently have an existing Working Capital loan?
*
–
Yes
No
Amount Requested
*
Please enter a number greater than or equal to
0
.
Disclaimer
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