Tell Us About Your Business

Complete the guided request below or call 321-607-2352. Submission does not constitute approval or a financing commitment.

Borrower Application

Step 1 of 6

Business Information

Legal business name

DBA

Entity type

State of formation

Business address

Website

Industry / NAICS

EIN

Date established

Ownership

Owner name

Ownership percentage

Phone

Guarantor information, if applicable

Funding Request

Amount requested

Financing type

Use of funds

Desired timing

Transaction

Financial Profile

Annual revenue

Average monthly revenue

Profitability

Existing business debt

Current monthly debt payments

Available collateral

Document Checklist

For your protection, do not upload confidential financial documents until Starmont Group provides access to its verified secure document portal. This public form collects only preliminary request information.

Typical documents may include business bank statements, business and personal tax returns, YTD P&L and balance sheet, debt schedule, identification, and transaction-specific records.

I understand that a funding specialist will provide secure document instructions if my request proceeds.

Authorization

By submitting, you authorize Starmont Group to contact you about this financing request. This preliminary form does not authorize a credit pull or document sharing. Any additional credit or lender-sharing authorization will be presented separately for review and electronic signature.

I confirm the information provided is accurate to the best of my knowledge.

I have read and accept the disclosures below.

Thank you. Your request has been prepared.

This demonstration currently protects your information by not transmitting or storing it. Before the live intake is activated, Starmont Group must connect its approved secure form, encrypted storage, CRM, notification, and e-signature services.

Email Starmont Group

Legal & Compliance

Legal Disclosures & Licensing

Starmont Group is a business financing broker, not a direct lender. All financing is subject to lender underwriting, credit approval, and applicable terms. Starmont Group does not guarantee approval, rates, or terms. Compensation may be lender-paid, borrower-paid, or a combination depending on the lender and product, and will be disclosed in writing before you become obligated.

Starmont Group is committed to equal access to credit consistent with the Equal Credit Opportunity Act and safeguards borrower information consistent with applicable data privacy and financial information laws.

Secure ApplicationEncrypted application and data-security practices.

Equal OpportunityCredit access consistent with ECOA and Regulation B.

Clear DisclosuresTransaction terms are provided by the applicable lender.

Broker IdentificationMLS ID# 2331121 — confirm final legal designation before launch.

E-SignatureElectronic consent workflow to follow ESIGN requirements.

PrivacyFinancial information handled under applicable privacy obligations.

Legal-review notice: Commercial financing disclosure rules vary by state, including California, New York, Utah, Virginia, Georgia, and Florida. Final licensing language, broker identification, agreements, compensation disclosures, borrower authorizations, privacy policy, and state-specific requirements must be reviewed by qualified counsel before the secure application is activated.