Complete Your Application

By signing below, you certify that you are authorized to sign this application on behalf of the above listed business and merchant owner(s) (individually and collectively "Applicant") and to certify that all information and supporting documentation submitted with this application is true, correct and complete, and all such information may be relied upon by Hightower Funding ("HF") and the Recipients (defined below). Applicant hereby authorizes HF and each of its representatives, successors, assigns and designees and third-party financial institutions and funding partners, which includes but is not limited to lenders, and other finance providers with whom HF has, or may in the future enter into, commercial-brokerage-financing relationships ("Recipients"): (1) to obtain consumer or personal, business credit and/or investigative reports from one or more consumer reporting agencies, such as TransUnion, Experian and Equifax and other information about you, including credit card processor statements and bank statements, (2) to obtain credit card processor statements and bank statements from banks, creditor and other third parties; (3) transmit this application form, along with any of the foregoing information obtained in connection with this application, to any or all the Recipients for the purposes of securing Applicant working capital; (4) to obtain the release, by any creditor or financial institution, of any information relating to you, and to share such information with any/all Recipients; and (5) to contact you via e-mail, call and/or text message at the e-mail address and/or phone number provided above, or at any e-mail address and/or phone number reasonably identified as belonging to you, including wireless numbers (if applicable), even if listed on a Do-Not-Call registry, using an automated telephone dialing system or other similar system with respect to this application, future-related commercial-financing opportunities and/or other lawful telemarketing purposes. Applicant further certifies that should any of the foregoing information change, to the extent within its knowledge, that Applicant will promptly notify HF of such changes.