COMPANY INFORMATION
BUSINESS OWNER
ADDITIONAL BUSINESS OWNER
FUNDING REQUEST
CERTIFICATION AND AGREEMENT

By signing and submitting to us this Application Form, you certify that (i) you are authorized to apply on behalf of the Company, the full legal name of which appears above under the Company Information portion of this Application Form, for funding for business purposes and (ii) all information you provided on this Application Form and other supporting documents is true and complete and you will notify us of any material changes to such information.

You understand and agree that Capital Source Group (“CSG”) may disclose all information and documents that we may obtain about Company or you to other persons or entities including third-party financial institutions (“Third-Parties”). You understand and agree that we and Third-Parties, including our agents and assignees, are authorized to contact third parties to make inquiries in evaluating this Application Form about Company or you (including requesting business and personal credit bureau reports from credit reporting agencies and other sources) or for any update, renewal, extension of funding or other lawful purpose and consent to any such contact or inquiries. Upon your request, CSG will advise you if CSG obtained a credit report and will give you the credit bureau’s name and address. Furthermore, you hereby give CSG and Third-Parties, including any affiliate, permission to contact you at any phone number you provide on or in connection with this application, including via text messages.