Apply Now

Legal Name of Business*
Legal Entity*
Date Established*
Trade Name (DBA)
Federal Tax ID*
DUNS#
Primary Business Address*
Street Address City State ZIP Code
Business Phone*
Business Email*
Industry*
How did you hear about us?
Facility Amount Requested*
Please enter a value between 0 and 10000000.00.
Projected Sales Next 12 Months*
Please enter a value between 0 and 10000000000.00.
Sales Last 12 Months*
Please enter a value between 0 and 10000000000.
Gross Margins*
Please enter a value between 0 and 100.
Net Margins*
Please enter a value between 0 and 100.

Save and Continue Later

Primary Contact Information
Please provide information for the person who will be our primary point of contact. The Primary contact must be able to sign documents on behalf of the legal entiry referenced above.
Name
First Last
Phone*
Email*
Address*
Street Address City State ZIP Code
Is the Primary contact also an Owner?*
Social Security Number*
Title*
Ownership Percentage*
Please enter a value between 0 and 100.
Do you need to add an Owner?*
- No
- Yes
Additional Owner/Officer Information
Please add all individuals or companies with 10% or great stake in the company. Total should equal 100%.
Name*
First Last
Phone*
Email*
Address*
Street Address City State ZIP Code
Social Security Number*
Title*
Ownership Percentage*
Please enter a value between 0 and 100.
Do you need to add another Owner?*
- No
- Yes
Additional Owner/Officer Information
Name*
First Last
Phone*
Email*
Address*
Street Address City State ZIP Code
Social Security Number*
Title*
Ownership Percentage*
Please enter a value between 0 and 100.

Save and Continue Later

Debtor Information
Please provide information for up to the Top 5 companies that you would like to sell your receivables for.
Company Name*
Credit Limit*
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Do you need to add a 2nd Debtor?
- Yes
- No
2nd Debtor Information
Company Name
Credit Limit
Address
Street Address City State / Province / Region ZIP / Postal Code Country
Do you need to add a 3rd Debtor?
- Yes
- No
3rd Debtor Information
Company Name
Credit Limit
Address
Street Address City State / Province / Region ZIP / Postal Code Country
Do you need to add a 4th Debtor?
- Yes
- No
4th Debtor Information
Company Name
Credit Limit
Address
Street Address City State / Province / Region ZIP / Postal Code Country
Do you need to add a 5th Debtor?
- Yes
- No
5th Debtor Information
Company Name
Credit Limit
Address
Street Address City State / Province / Region ZIP / Postal Code Country

Save and Continue Later

Upload Documents
We understand you might not have all these documents. If not, that's ok. You can always get these to us later.
Current Balance Sheet
Drop files here or
Current Income Statement
Drop files here or
Current AR Aging
Drop files here or
Current AP Aging
Drop files here or
Drivers License(s)
Drop files here or
Corporate Documents
Drop files here or
Please include Articles of Incorporation, Certificate of Filing, IRS FEIN Letter, etc.
Other Items
Drop files here or

Save and Continue Later

You Are Just About Done!
Certification*
- I agree to the terms.
I hereby certify on behalf of Applicant that the information provided in this Application is true, accurate and complete. Permission is hereby granted for a confidential credit investigation. A copy of this form shall be good and sufficient authority for anyone having confidential or other information about the financial position of Applicant to disclose such information to Uber Business Capital (“ UBC”) upon request. If representations are subsequently found to be incorrect or incomplete, UBC reserves the right to reject this application and cancel any contract that may be negotiated and shall not be obliged to fulfil any agreement with Applicant, verbal or written. Applicant agrees that any expenses incurred by UBC, because of reliance by it upon incomplete or incorrect statements made by Applicant herein are chargeable to the Applicant. I have read and accept UBC’s Privacy Policy posted on the Uber Business Capital’s websites (including www.uberbc.com). I consent to UBC and its affiliates sending me electronic messages with respect to the services provided by them. I understand that I may withdraw my consent at any time.
Date
Signature*
Name*
First Last
Title*

Save and Continue Later

Primary Contact Information