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Submitted URL: http://txhd.io/r/#m0EAc
Effective URL: https://www.cognitoforms.com/SterlingFinancialCo/BusinessFinancingApplication
Submission: On December 05 via manual from HR — Scanned from DE
Effective URL: https://www.cognitoforms.com/SterlingFinancialCo/BusinessFinancingApplication
Submission: On December 05 via manual from HR — Scanned from DE
Form analysis 1 forms found in the DOM
<form lang="en" tabindex="-1" class="😉 cog-cognito cog-form cog-1 is-default cog-cognito--styled cog-form--light-background" data-stretch="" data-width="800 700 650 625 600 575 550 525 500 475 450 425 400 375 350 325 300 275 250 225 200">
<div class="cog-form__container">
<div class="cog-form__content">
<header class="cog-header cog-wrapper cog-header--column cog-header--center"><img src="https://www.cognitoforms.com/file/skfVf4AuoKFG9vUeVQQr9AXDDOPnq8Wbk7ZWxEllRzLgxCX-hW-K93UkU_oPqXB3">
<div class="cog-header__text">
<h1 class="cog-heading">Business Financing Application</h1> <!---->
</div>
</header>
<div class="cog-body"><!---->
<div class="cog-page cog-wrapper cog-transition-ltr">
<div class="cog-row">
<section aria-labelledby="cog-6" tabindex="-1" class="cog-section cog-col cog-col--24 cog-section--heading cog-field--13">
<div class="cog-section__inner cog-section__inner--no-background ">
<h2 id="cog-6" class="cog-section__heading cog-heading"> BUSINESS INFORMATION <!----></h2> <!---->
<div class="cog-row">
<div class="cog-field cog-field--1 cog-col cog-col--12 cog-text cog-text--singleline is-required"><label id="cog-7-label" for="cog-7" class="cog-label"> Legal/​Corporate NameName:<span aria-hidden="true"
class="cog-asterisk">*</span> <span class="cog-offscreen">(required)</span> <!----></label>
<div class="cog-input">
<div class="el-input"><!----><input type="text" autocomplete="off" id="cog-7" placeholder="" class="el-input__inner"><!----><!----><!----><!----></div>
</div>
<div class="cog-field__placeholder cog-input">
<div class="cog-field__placeholder-inner"> </div>
</div> <!----> <!----> <!---->
</div>
<div class="cog-field cog-field--2 cog-col cog-col--12 cog-text cog-text--singleline is-required"><label id="cog-8-label" for="cog-8" class="cog-label"> DBA:<span aria-hidden="true" class="cog-asterisk">*</span> <span
class="cog-offscreen">(required)</span> <!----></label>
<div class="cog-input">
<div class="el-input"><!----><input type="text" autocomplete="off" id="cog-8" placeholder="" class="el-input__inner"><!----><!----><!----><!----></div>
</div>
<div class="cog-field__placeholder cog-input">
<div class="cog-field__placeholder-inner"> </div>
</div> <!----> <!----> <!---->
</div>
</div>
<div class="cog-row">
<fieldset class="cog-field cog-field--3 cog-col cog-col--24 cog-address cog-address--us is-required">
<legend class="cog-label"> Physical Address:<span aria-hidden="true" class="cog-asterisk">*</span> <span class="cog-offscreen">(required)</span> <!----></legend>
<div class="cog-address">
<div class="cog-row">
<div class="cog-input cog-address__street cog-input--full">
<div class="el-input"><!----><input type="text" autocomplete="address-line1" id="cog-9-line1" placeholder="Address Line 1" title="Address Line 1" class="el-input__inner"><!----><!----><!----><!----></div>
</div>
<div class="cog-input cog-address__line-2 cog-input--full">
<div class="el-input"><!----><input type="text" autocomplete="address-line2" id="cog-9-line2" placeholder="Address Line 2" title="Address Line 2" class="el-input__inner"><!----><!----><!----><!----></div>
</div> <!---->
<div class="cog-input cog-address__city cog-input--long">
<div class="el-input"><!----><input type="text" autocomplete="address-level2" id="cog-9-city" placeholder="City" title="City" class="el-input__inner"><!----><!----><!----><!----></div>
</div>
<div class="cog-picker cog-select cog-input cog-address__state cog-input--long">
<div class="el-select el-select--dropdown-bottom"><!---->
<div class="el-input el-input--prefix el-input--suffix"><!----><input type="text" autocomplete="address-level1" placeholder="State" title="State" id="cog-9-state" aria-controls="cog-9-state-listbox" role="combobox"
aria-haspopup="listbox" aria-owns="cog-9-state-listbox" aria-expanded="false" class="el-input__inner" aria-activedescendant="cog-9-state-option-null" style="height: 34.8906px;"><span class="el-input__prefix"><span><svg
viewBox="0 0 18 18" focusable="false" class="cog-icon cog-i-chevron">
<g>
<path stroke-linecap="square" d="M3 7l6 6 6-6"></path>
</g>
</svg></span><!----></span><span class="el-input__suffix"><span
class="el-input__suffix-inner"><!----><i class="el-select__caret el-input__icon el-icon-arrow-up"></i><!----><!----><!----><!----><!----></span><!----></span><!----><!----></div>
<div class="el-select-dropdown el-popper cog-cognito cog-1 cog-cognito--styled cog-select-popper " style="display: none; min-width: 283.281px;">
<div class="el-scrollbar" style="">
<div class="el-select-dropdown__wrap el-scrollbar__wrap el-scrollbar__wrap--hidden-default">
<ul id="cog-9-state-listbox" role="listbox" class="el-scrollbar__view el-select-dropdown__list"><!---->
<li role="option" id="cog-9-state-option-null" aria-selected="true" class="el-select-dropdown__item cog-select-option--empty selected hover"> </li>
<li role="option" id="cog-9-state-option-Armed Forces America" aria-selected="false" class="el-select-dropdown__item" style="order: 0;"><span>Armed Forces America</span></li>
<li role="option" id="cog-9-state-option-Armed Forces" aria-selected="false" class="el-select-dropdown__item" style="order: 1;"><span>Armed Forces</span></li>
<li role="option" id="cog-9-state-option-Armed Forces Pacific" aria-selected="false" class="el-select-dropdown__item" style="order: 2;"><span>Armed Forces Pacific</span></li>
<li role="option" id="cog-9-state-option-Alabama" aria-selected="false" class="el-select-dropdown__item" style="order: 3;"><span>Alabama</span></li>
<li role="option" id="cog-9-state-option-Alaska" aria-selected="false" class="el-select-dropdown__item" style="order: 4;"><span>Alaska</span></li>
<li role="option" id="cog-9-state-option-American Samoa" aria-selected="false" class="el-select-dropdown__item" style="order: 5;"><span>American Samoa</span></li>
<li role="option" id="cog-9-state-option-Arizona" aria-selected="false" class="el-select-dropdown__item" style="order: 6;"><span>Arizona</span></li>
<li role="option" id="cog-9-state-option-Arkansas" aria-selected="false" class="el-select-dropdown__item" style="order: 7;"><span>Arkansas</span></li>
<li role="option" id="cog-9-state-option-California" aria-selected="false" class="el-select-dropdown__item" style="order: 8;"><span>California</span></li>
<li role="option" id="cog-9-state-option-Colorado" aria-selected="false" class="el-select-dropdown__item" style="order: 9;"><span>Colorado</span></li>
<li role="option" id="cog-9-state-option-Connecticut" aria-selected="false" class="el-select-dropdown__item" style="order: 10;"><span>Connecticut</span></li>
<li role="option" id="cog-9-state-option-Delaware" aria-selected="false" class="el-select-dropdown__item" style="order: 11;"><span>Delaware</span></li>
<li role="option" id="cog-9-state-option-District of Columbia" aria-selected="false" class="el-select-dropdown__item" style="order: 12;"><span>District of Columbia</span></li>
<li role="option" id="cog-9-state-option-Florida" aria-selected="false" class="el-select-dropdown__item" style="order: 13;"><span>Florida</span></li>
<li role="option" id="cog-9-state-option-Georgia" aria-selected="false" class="el-select-dropdown__item" style="order: 14;"><span>Georgia</span></li>
<li role="option" id="cog-9-state-option-Guam" aria-selected="false" class="el-select-dropdown__item" style="order: 15;"><span>Guam</span></li>
<li role="option" id="cog-9-state-option-Hawaii" aria-selected="false" class="el-select-dropdown__item" style="order: 16;"><span>Hawaii</span></li>
<li role="option" id="cog-9-state-option-Idaho" aria-selected="false" class="el-select-dropdown__item" style="order: 17;"><span>Idaho</span></li>
<li role="option" id="cog-9-state-option-Illinois" aria-selected="false" class="el-select-dropdown__item" style="order: 18;"><span>Illinois</span></li>
<li role="option" id="cog-9-state-option-Indiana" aria-selected="false" class="el-select-dropdown__item" style="order: 19;"><span>Indiana</span></li>
<li role="option" id="cog-9-state-option-Iowa" aria-selected="false" class="el-select-dropdown__item" style="order: 20;"><span>Iowa</span></li>
<li role="option" id="cog-9-state-option-Kansas" aria-selected="false" class="el-select-dropdown__item" style="order: 21;"><span>Kansas</span></li>
<li role="option" id="cog-9-state-option-Kentucky" aria-selected="false" class="el-select-dropdown__item" style="order: 22;"><span>Kentucky</span></li>
<li role="option" id="cog-9-state-option-Louisiana" aria-selected="false" class="el-select-dropdown__item" style="order: 23;"><span>Louisiana</span></li>
<li role="option" id="cog-9-state-option-Maine" aria-selected="false" class="el-select-dropdown__item" style="order: 24;"><span>Maine</span></li>
<li role="option" id="cog-9-state-option-Maryland" aria-selected="false" class="el-select-dropdown__item" style="order: 25;"><span>Maryland</span></li>
<li role="option" id="cog-9-state-option-Massachusetts" aria-selected="false" class="el-select-dropdown__item" style="order: 26;"><span>Massachusetts</span></li>
<li role="option" id="cog-9-state-option-Michigan" aria-selected="false" class="el-select-dropdown__item" style="order: 27;"><span>Michigan</span></li>
<li role="option" id="cog-9-state-option-Minnesota" aria-selected="false" class="el-select-dropdown__item" style="order: 28;"><span>Minnesota</span></li>
<li role="option" id="cog-9-state-option-Mississippi" aria-selected="false" class="el-select-dropdown__item" style="order: 29;"><span>Mississippi</span></li>
<li role="option" id="cog-9-state-option-Missouri" aria-selected="false" class="el-select-dropdown__item" style="order: 30;"><span>Missouri</span></li>
<li role="option" id="cog-9-state-option-Montana" aria-selected="false" class="el-select-dropdown__item" style="order: 31;"><span>Montana</span></li>
<li role="option" id="cog-9-state-option-Nebraska" aria-selected="false" class="el-select-dropdown__item" style="order: 32;"><span>Nebraska</span></li>
<li role="option" id="cog-9-state-option-Nevada" aria-selected="false" class="el-select-dropdown__item" style="order: 33;"><span>Nevada</span></li>
<li role="option" id="cog-9-state-option-New Hampshire" aria-selected="false" class="el-select-dropdown__item" style="order: 34;"><span>New Hampshire</span></li>
<li role="option" id="cog-9-state-option-New Jersey" aria-selected="false" class="el-select-dropdown__item" style="order: 35;"><span>New Jersey</span></li>
<li role="option" id="cog-9-state-option-New Mexico" aria-selected="false" class="el-select-dropdown__item" style="order: 36;"><span>New Mexico</span></li>
<li role="option" id="cog-9-state-option-New York" aria-selected="false" class="el-select-dropdown__item" style="order: 37;"><span>New York</span></li>
<li role="option" id="cog-9-state-option-North Carolina" aria-selected="false" class="el-select-dropdown__item" style="order: 38;"><span>North Carolina</span></li>
<li role="option" id="cog-9-state-option-North Dakota" aria-selected="false" class="el-select-dropdown__item" style="order: 39;"><span>North Dakota</span></li>
<li role="option" id="cog-9-state-option-Northern Mariana Islands" aria-selected="false" class="el-select-dropdown__item" style="order: 40;"><span>Northern Mariana Islands</span></li>
<li role="option" id="cog-9-state-option-Ohio" aria-selected="false" class="el-select-dropdown__item" style="order: 41;"><span>Ohio</span></li>
<li role="option" id="cog-9-state-option-Oklahoma" aria-selected="false" class="el-select-dropdown__item" style="order: 42;"><span>Oklahoma</span></li>
<li role="option" id="cog-9-state-option-Oregon" aria-selected="false" class="el-select-dropdown__item" style="order: 43;"><span>Oregon</span></li>
<li role="option" id="cog-9-state-option-Pennsylvania" aria-selected="false" class="el-select-dropdown__item" style="order: 44;"><span>Pennsylvania</span></li>
<li role="option" id="cog-9-state-option-Puerto Rico" aria-selected="false" class="el-select-dropdown__item" style="order: 45;"><span>Puerto Rico</span></li>
<li role="option" id="cog-9-state-option-Rhode Island" aria-selected="false" class="el-select-dropdown__item" style="order: 46;"><span>Rhode Island</span></li>
<li role="option" id="cog-9-state-option-South Carolina" aria-selected="false" class="el-select-dropdown__item" style="order: 47;"><span>South Carolina</span></li>
<li role="option" id="cog-9-state-option-South Dakota" aria-selected="false" class="el-select-dropdown__item" style="order: 48;"><span>South Dakota</span></li>
<li role="option" id="cog-9-state-option-Tennessee" aria-selected="false" class="el-select-dropdown__item" style="order: 49;"><span>Tennessee</span></li>
<li role="option" id="cog-9-state-option-Texas" aria-selected="false" class="el-select-dropdown__item" style="order: 50;"><span>Texas</span></li>
<li role="option" id="cog-9-state-option-Utah" aria-selected="false" class="el-select-dropdown__item" style="order: 51;"><span>Utah</span></li>
<li role="option" id="cog-9-state-option-Vermont" aria-selected="false" class="el-select-dropdown__item" style="order: 52;"><span>Vermont</span></li>
<li role="option" id="cog-9-state-option-Virgin Islands" aria-selected="false" class="el-select-dropdown__item" style="order: 53;"><span>Virgin Islands</span></li>
<li role="option" id="cog-9-state-option-Virginia" aria-selected="false" class="el-select-dropdown__item" style="order: 54;"><span>Virginia</span></li>
<li role="option" id="cog-9-state-option-Washington" aria-selected="false" class="el-select-dropdown__item" style="order: 55;"><span>Washington</span></li>
<li role="option" id="cog-9-state-option-West Virginia" aria-selected="false" class="el-select-dropdown__item" style="order: 56;"><span>West Virginia</span></li>
<li role="option" id="cog-9-state-option-Wisconsin" aria-selected="false" class="el-select-dropdown__item" style="order: 57;"><span>Wisconsin</span></li>
<li role="option" id="cog-9-state-option-Wyoming" aria-selected="false" class="el-select-dropdown__item" style="order: 58;"><span>Wyoming</span></li>
</ul>
</div><!----><!---->
</div><!---->
</div>
</div>
</div> <!---->
<div class="cog-input cog-address__postal-code cog-input--medium">
<div class="el-input"><!----><input type="text" autocomplete="postal-code" id="cog-9-zip-code" placeholder="Zip Code" title="Zip Code" class="el-input__inner"><!----><!----><!----><!----></div>
</div> <!----> <!---->
</div>
</div>
<div class="cog-field__placeholder cog-input">
<div class="cog-field__placeholder-inner"> </div>
</div> <!----> <!----> <!---->
</fieldset>
</div>
<div class="cog-row">
<div class="cog-field cog-field--4 cog-col cog-col--8 cog-phone cog-phone--us is-required"><label id="cog-10-label" for="cog-10" class="cog-label"> Telephone #:<span aria-hidden="true" class="cog-asterisk">*</span> <span
class="cog-offscreen">(required)</span> <!----></label>
<div class="cog-input">
<div class="el-input"><!----><input type="text" autocomplete="tel-national" id="cog-10" placeholder="" class="el-input__inner"><!----><!----><!----><!----></div>
</div>
<div class="cog-field__placeholder cog-input">
<div class="cog-field__placeholder-inner"> </div>
</div> <!----> <!----> <!---->
</div>
<div class="cog-field cog-field--5 cog-col cog-col--8 cog-date cog-date--date"><label id="cog-11-label" for="cog-11" class="cog-label"> Date Business Started:<!----> <!----> <!----></label>
<div class="cog-picker cog-input">
<div class="el-date-editor el-input el-input--prefix el-input--suffix el-date-editor--date"><!----><input type="text" autocomplete="off" name="" id="cog-11" class="el-input__inner"><span class="el-input__prefix"><span><svg
viewBox="0 0 18 18" focusable="false" class="cog-icon cog-i-calendar">
<defs></defs>
<g>
<path d="M2.5 3.5h13v12h-13z"></path>
<path d="M4.02 7.5h9.88" class="cog-i-calendar__rule"></path>
<path d="M5.5 5V1.5M12.5 5V1.5"></path>
</g>
</svg></span><!----></span><span class="el-input__suffix"><span class="el-input__suffix-inner"><i class="el-input__icon"></i><!----><!----><!----><!----></span><!----></span><!----><!----></div>
</div>
<div class="cog-field__placeholder cog-input">
<div class="cog-field__placeholder-inner"> </div>
</div> <!----> <!----> <!---->
</div>
<div class="cog-field cog-field--11 cog-col cog-col--8 cog-text cog-text--singleline is-required"><label id="cog-12-label" for="cog-12" class="cog-label"> Federal Tax ID:<span aria-hidden="true" class="cog-asterisk">*</span> <span
class="cog-offscreen">(required)</span> <!----></label>
<div class="cog-input">
<div class="el-input"><!----><input type="text" autocomplete="off" id="cog-12" placeholder="" class="el-input__inner"><!----><!----><!----><!----></div>
</div>
<div class="cog-field__placeholder cog-input">
<div class="cog-field__placeholder-inner"> </div>
</div> <!----> <!----> <!---->
</div>
</div>
<div class="cog-row">
<fieldset class="cog-field cog-field--7 cog-col cog-col--12 cog-choice cog-choice--checkboxes is-required">
<legend class="cog-label"> Type of Entity (check one):<span aria-hidden="true" class="cog-asterisk">*</span> <span class="cog-offscreen">(required)</span> <!----></legend>
<div class="cog-choice">
<div class="cog-checkable cog-input cog-checkable--inline">
<div aria-label="checkbox-group" class="el-checkbox-group"><label class="el-checkbox cog-checkable__item"><span class="el-checkbox__input"><span class="el-checkbox__inner"></span><input type="checkbox"
class="el-checkbox__original" value="Sole Proprietorship"></span><span class="el-checkbox__label"> Sole Proprietorship <!----></span></label><label class="el-checkbox cog-checkable__item"><span
class="el-checkbox__input"><span class="el-checkbox__inner"></span><input type="checkbox" class="el-checkbox__original" value="Partnership"></span><span class="el-checkbox__label"> Partnership
<!----></span></label><label class="el-checkbox cog-checkable__item"><span class="el-checkbox__input"><span class="el-checkbox__inner"></span><input type="checkbox" class="el-checkbox__original"
value="Corporation"></span><span class="el-checkbox__label"> Corporation <!----></span></label><label class="el-checkbox cog-checkable__item"><span class="el-checkbox__input"><span
class="el-checkbox__inner"></span><input type="checkbox" class="el-checkbox__original" value="LLC"></span><span class="el-checkbox__label"> LLC <!----></span></label><label class="el-checkbox cog-checkable__item"><span
class="el-checkbox__input"><span class="el-checkbox__inner"></span><input type="checkbox" class="el-checkbox__original" value="Other"></span><span class="el-checkbox__label"> Other <!----></span></label> <!----></div>
</div>
<div class="cog-choice__placeholder">
<div>
<div class="cog-choice__checkable-placeholder"><span>Sole Proprietorship</span></div>
<div class="cog-choice__checkable-placeholder"><span>Partnership</span></div>
<div class="cog-choice__checkable-placeholder"><span>Corporation</span></div>
<div class="cog-choice__checkable-placeholder"><span>LLC</span></div>
<div class="cog-choice__checkable-placeholder"><span>Other</span></div> <!---->
</div>
</div>
</div>
<div class="cog-field__placeholder cog-input">
<div class="cog-field__placeholder-inner"> </div>
</div> <!----> <!----> <!---->
</fieldset>
<div class="cog-field cog-field--8 cog-col cog-col--12 cog-email is-required"><label id="cog-14-label" for="cog-14" class="cog-label"> Email Address:<span aria-hidden="true" class="cog-asterisk">*</span> <span
class="cog-offscreen">(required)</span> <!----></label>
<div class="cog-input">
<div class="el-input"><!----><input type="text" autocomplete="email" id="cog-14" placeholder="" class="el-input__inner"><!----><!----><!----><!----></div>
</div>
<div class="cog-field__placeholder cog-input">
<div class="cog-field__placeholder-inner"> </div>
</div> <!----> <!----> <!---->
</div>
</div>
<div class="cog-row">
<fieldset class="cog-field cog-field--9 cog-col cog-col--12 cog-choice cog-choice--checkboxes is-required">
<legend class="cog-label"> Type of Business (check all that apply):<span aria-hidden="true" class="cog-asterisk">*</span> <span class="cog-offscreen">(required)</span> <!----></legend>
<div class="cog-choice">
<div class="cog-checkable cog-input cog-checkable--inline">
<div aria-label="checkbox-group" class="el-checkbox-group"><label class="el-checkbox cog-checkable__item"><span class="el-checkbox__input"><span class="el-checkbox__inner"></span><input type="checkbox"
class="el-checkbox__original" value="Retail"></span><span class="el-checkbox__label"> Retail <!----></span></label><label class="el-checkbox cog-checkable__item"><span class="el-checkbox__input"><span
class="el-checkbox__inner"></span><input type="checkbox" class="el-checkbox__original" value="Wholesale"></span><span class="el-checkbox__label"> Wholesale <!----></span></label><label
class="el-checkbox cog-checkable__item"><span class="el-checkbox__input"><span class="el-checkbox__inner"></span><input type="checkbox" class="el-checkbox__original" value="Construction"></span><span
class="el-checkbox__label"> Construction <!----></span></label><label class="el-checkbox cog-checkable__item"><span class="el-checkbox__input"><span class="el-checkbox__inner"></span><input type="checkbox"
class="el-checkbox__original" value="Transportation"></span><span class="el-checkbox__label"> Transportation <!----></span></label><label class="el-checkbox cog-checkable__item"><span class="el-checkbox__input"><span
class="el-checkbox__inner"></span><input type="checkbox" class="el-checkbox__original" value="Other"></span><span class="el-checkbox__label"> Other <!----></span></label> <!----></div>
</div>
<div class="cog-choice__placeholder">
<div>
<div class="cog-choice__checkable-placeholder"><span>Retail</span></div>
<div class="cog-choice__checkable-placeholder"><span>Wholesale</span></div>
<div class="cog-choice__checkable-placeholder"><span>Construction</span></div>
<div class="cog-choice__checkable-placeholder"><span>Transportation</span></div>
<div class="cog-choice__checkable-placeholder"><span>Other</span></div> <!---->
</div>
</div>
</div>
<div class="cog-field__placeholder cog-input">
<div class="cog-field__placeholder-inner"> </div>
</div> <!----> <!----> <!---->
</fieldset>
<div class="cog-field cog-field--10 cog-col cog-col--12 cog-text cog-text--singleline is-required"><label id="cog-16-label" for="cog-16" class="cog-label"> Product/​Service Sold:<span aria-hidden="true" class="cog-asterisk">*</span>
<span class="cog-offscreen">(required)</span> <!----></label>
<div class="cog-input">
<div class="el-input"><!----><input type="text" autocomplete="off" id="cog-16" placeholder="" class="el-input__inner"><!----><!----><!----><!----></div>
</div>
<div class="cog-field__placeholder cog-input">
<div class="cog-field__placeholder-inner"> </div>
</div> <!----> <!----> <!---->
</div>
</div>
</div> <!---->
</section>
</div>
<div class="cog-row">
<section aria-labelledby="cog-17" tabindex="-1" class="cog-section cog-col cog-col--24 cog-section--heading cog-field--12">
<div class="cog-section__inner cog-section__inner--no-background ">
<h2 id="cog-17" class="cog-section__heading cog-heading"> MERCHANT/OWNER INFORMATION <!----></h2> <!---->
<div class="cog-row">
<div class="cog-field cog-field--1 cog-col cog-col--8 cog-text cog-text--singleline is-required"><label id="cog-18-label" for="cog-18" class="cog-label"> Corporate Officer /​ Owner Name:<span aria-hidden="true"
class="cog-asterisk">*</span> <span class="cog-offscreen">(required)</span> <!----></label>
<div class="cog-input">
<div class="el-input"><!----><input type="text" autocomplete="off" id="cog-18" placeholder="" class="el-input__inner"><!----><!----><!----><!----></div>
</div>
<div class="cog-field__placeholder cog-input">
<div class="cog-field__placeholder-inner"> </div>
</div> <!----> <!----> <!---->
</div>
<div class="cog-field cog-field--2 cog-col cog-col--8 cog-text cog-text--singleline is-required"><label id="cog-19-label" for="cog-19" class="cog-label"> Title:<span aria-hidden="true" class="cog-asterisk">*</span> <span
class="cog-offscreen">(required)</span> <!----></label>
<div class="cog-input">
<div class="el-input"><!----><input type="text" autocomplete="off" id="cog-19" placeholder="" class="el-input__inner"><!----><!----><!----><!----></div>
</div>
<div class="cog-field__placeholder cog-input">
<div class="cog-field__placeholder-inner"> </div>
</div> <!----> <!----> <!---->
</div>
<div class="cog-field cog-field--3 cog-col cog-col--8 cog-number cog-number--percent is-required"><label id="cog-20-label" for="cog-20" class="cog-label"> Ownership %:<span aria-hidden="true" class="cog-asterisk">*</span> <span
class="cog-offscreen">(required)</span> <!----></label>
<div class="cog-input">
<div class="el-input"><!----><input type="text" autocomplete="off" id="cog-20" placeholder="" inputmode="" class="el-input__inner"><!----><!----><!----><!----></div>
</div>
<div class="cog-field__placeholder cog-input">
<div class="cog-field__placeholder-inner"> </div>
</div> <!----> <!----> <!---->
</div>
</div>
<div class="cog-row">
<fieldset class="cog-field cog-field--4 cog-col cog-col--24 cog-address cog-address--us is-required">
<legend class="cog-label"> Home Address:<span aria-hidden="true" class="cog-asterisk">*</span> <span class="cog-offscreen">(required)</span> <!----></legend>
<div class="cog-address">
<div class="cog-row">
<div class="cog-input cog-address__street cog-input--full">
<div class="el-input"><!----><input type="text" autocomplete="address-line1" id="cog-21-line1" placeholder="Address Line 1" title="Address Line 1" class="el-input__inner"><!----><!----><!----><!----></div>
</div>
<div class="cog-input cog-address__line-2 cog-input--full">
<div class="el-input"><!----><input type="text" autocomplete="address-line2" id="cog-21-line2" placeholder="Address Line 2" title="Address Line 2" class="el-input__inner"><!----><!----><!----><!----></div>
</div> <!---->
<div class="cog-input cog-address__city cog-input--long">
<div class="el-input"><!----><input type="text" autocomplete="address-level2" id="cog-21-city" placeholder="City" title="City" class="el-input__inner"><!----><!----><!----><!----></div>
</div>
<div class="cog-picker cog-select cog-input cog-address__state cog-input--long">
<div class="el-select el-select--dropdown-bottom"><!---->
<div class="el-input el-input--prefix el-input--suffix"><!----><input type="text" autocomplete="address-level1" placeholder="State" title="State" id="cog-21-state" aria-controls="cog-21-state-listbox" role="combobox"
aria-haspopup="listbox" aria-owns="cog-21-state-listbox" aria-expanded="false" class="el-input__inner" aria-activedescendant="cog-21-state-option-null" style="height: 34.8906px;"><span
class="el-input__prefix"><span><svg viewBox="0 0 18 18" focusable="false" class="cog-icon cog-i-chevron">
<g>
<path stroke-linecap="square" d="M3 7l6 6 6-6"></path>
</g>
</svg></span><!----></span><span class="el-input__suffix"><span
class="el-input__suffix-inner"><!----><i class="el-select__caret el-input__icon el-icon-arrow-up"></i><!----><!----><!----><!----><!----></span><!----></span><!----><!----></div>
<div class="el-select-dropdown el-popper cog-cognito cog-1 cog-cognito--styled cog-select-popper " style="display: none; min-width: 283.281px;">
<div class="el-scrollbar" style="">
<div class="el-select-dropdown__wrap el-scrollbar__wrap el-scrollbar__wrap--hidden-default">
<ul id="cog-21-state-listbox" role="listbox" class="el-scrollbar__view el-select-dropdown__list"><!---->
<li role="option" id="cog-21-state-option-null" aria-selected="true" class="el-select-dropdown__item cog-select-option--empty selected hover"> </li>
<li role="option" id="cog-21-state-option-Armed Forces America" aria-selected="false" class="el-select-dropdown__item" style="order: 0;"><span>Armed Forces America</span></li>
<li role="option" id="cog-21-state-option-Armed Forces" aria-selected="false" class="el-select-dropdown__item" style="order: 1;"><span>Armed Forces</span></li>
<li role="option" id="cog-21-state-option-Armed Forces Pacific" aria-selected="false" class="el-select-dropdown__item" style="order: 2;"><span>Armed Forces Pacific</span></li>
<li role="option" id="cog-21-state-option-Alabama" aria-selected="false" class="el-select-dropdown__item" style="order: 3;"><span>Alabama</span></li>
<li role="option" id="cog-21-state-option-Alaska" aria-selected="false" class="el-select-dropdown__item" style="order: 4;"><span>Alaska</span></li>
<li role="option" id="cog-21-state-option-American Samoa" aria-selected="false" class="el-select-dropdown__item" style="order: 5;"><span>American Samoa</span></li>
<li role="option" id="cog-21-state-option-Arizona" aria-selected="false" class="el-select-dropdown__item" style="order: 6;"><span>Arizona</span></li>
<li role="option" id="cog-21-state-option-Arkansas" aria-selected="false" class="el-select-dropdown__item" style="order: 7;"><span>Arkansas</span></li>
<li role="option" id="cog-21-state-option-California" aria-selected="false" class="el-select-dropdown__item" style="order: 8;"><span>California</span></li>
<li role="option" id="cog-21-state-option-Colorado" aria-selected="false" class="el-select-dropdown__item" style="order: 9;"><span>Colorado</span></li>
<li role="option" id="cog-21-state-option-Connecticut" aria-selected="false" class="el-select-dropdown__item" style="order: 10;"><span>Connecticut</span></li>
<li role="option" id="cog-21-state-option-Delaware" aria-selected="false" class="el-select-dropdown__item" style="order: 11;"><span>Delaware</span></li>
<li role="option" id="cog-21-state-option-District of Columbia" aria-selected="false" class="el-select-dropdown__item" style="order: 12;"><span>District of Columbia</span></li>
<li role="option" id="cog-21-state-option-Florida" aria-selected="false" class="el-select-dropdown__item" style="order: 13;"><span>Florida</span></li>
<li role="option" id="cog-21-state-option-Georgia" aria-selected="false" class="el-select-dropdown__item" style="order: 14;"><span>Georgia</span></li>
<li role="option" id="cog-21-state-option-Guam" aria-selected="false" class="el-select-dropdown__item" style="order: 15;"><span>Guam</span></li>
<li role="option" id="cog-21-state-option-Hawaii" aria-selected="false" class="el-select-dropdown__item" style="order: 16;"><span>Hawaii</span></li>
<li role="option" id="cog-21-state-option-Idaho" aria-selected="false" class="el-select-dropdown__item" style="order: 17;"><span>Idaho</span></li>
<li role="option" id="cog-21-state-option-Illinois" aria-selected="false" class="el-select-dropdown__item" style="order: 18;"><span>Illinois</span></li>
<li role="option" id="cog-21-state-option-Indiana" aria-selected="false" class="el-select-dropdown__item" style="order: 19;"><span>Indiana</span></li>
<li role="option" id="cog-21-state-option-Iowa" aria-selected="false" class="el-select-dropdown__item" style="order: 20;"><span>Iowa</span></li>
<li role="option" id="cog-21-state-option-Kansas" aria-selected="false" class="el-select-dropdown__item" style="order: 21;"><span>Kansas</span></li>
<li role="option" id="cog-21-state-option-Kentucky" aria-selected="false" class="el-select-dropdown__item" style="order: 22;"><span>Kentucky</span></li>
<li role="option" id="cog-21-state-option-Louisiana" aria-selected="false" class="el-select-dropdown__item" style="order: 23;"><span>Louisiana</span></li>
<li role="option" id="cog-21-state-option-Maine" aria-selected="false" class="el-select-dropdown__item" style="order: 24;"><span>Maine</span></li>
<li role="option" id="cog-21-state-option-Maryland" aria-selected="false" class="el-select-dropdown__item" style="order: 25;"><span>Maryland</span></li>
<li role="option" id="cog-21-state-option-Massachusetts" aria-selected="false" class="el-select-dropdown__item" style="order: 26;"><span>Massachusetts</span></li>
<li role="option" id="cog-21-state-option-Michigan" aria-selected="false" class="el-select-dropdown__item" style="order: 27;"><span>Michigan</span></li>
<li role="option" id="cog-21-state-option-Minnesota" aria-selected="false" class="el-select-dropdown__item" style="order: 28;"><span>Minnesota</span></li>
<li role="option" id="cog-21-state-option-Mississippi" aria-selected="false" class="el-select-dropdown__item" style="order: 29;"><span>Mississippi</span></li>
<li role="option" id="cog-21-state-option-Missouri" aria-selected="false" class="el-select-dropdown__item" style="order: 30;"><span>Missouri</span></li>
<li role="option" id="cog-21-state-option-Montana" aria-selected="false" class="el-select-dropdown__item" style="order: 31;"><span>Montana</span></li>
<li role="option" id="cog-21-state-option-Nebraska" aria-selected="false" class="el-select-dropdown__item" style="order: 32;"><span>Nebraska</span></li>
<li role="option" id="cog-21-state-option-Nevada" aria-selected="false" class="el-select-dropdown__item" style="order: 33;"><span>Nevada</span></li>
<li role="option" id="cog-21-state-option-New Hampshire" aria-selected="false" class="el-select-dropdown__item" style="order: 34;"><span>New Hampshire</span></li>
<li role="option" id="cog-21-state-option-New Jersey" aria-selected="false" class="el-select-dropdown__item" style="order: 35;"><span>New Jersey</span></li>
<li role="option" id="cog-21-state-option-New Mexico" aria-selected="false" class="el-select-dropdown__item" style="order: 36;"><span>New Mexico</span></li>
<li role="option" id="cog-21-state-option-New York" aria-selected="false" class="el-select-dropdown__item" style="order: 37;"><span>New York</span></li>
<li role="option" id="cog-21-state-option-North Carolina" aria-selected="false" class="el-select-dropdown__item" style="order: 38;"><span>North Carolina</span></li>
<li role="option" id="cog-21-state-option-North Dakota" aria-selected="false" class="el-select-dropdown__item" style="order: 39;"><span>North Dakota</span></li>
<li role="option" id="cog-21-state-option-Northern Mariana Islands" aria-selected="false" class="el-select-dropdown__item" style="order: 40;"><span>Northern Mariana Islands</span></li>
<li role="option" id="cog-21-state-option-Ohio" aria-selected="false" class="el-select-dropdown__item" style="order: 41;"><span>Ohio</span></li>
<li role="option" id="cog-21-state-option-Oklahoma" aria-selected="false" class="el-select-dropdown__item" style="order: 42;"><span>Oklahoma</span></li>
<li role="option" id="cog-21-state-option-Oregon" aria-selected="false" class="el-select-dropdown__item" style="order: 43;"><span>Oregon</span></li>
<li role="option" id="cog-21-state-option-Pennsylvania" aria-selected="false" class="el-select-dropdown__item" style="order: 44;"><span>Pennsylvania</span></li>
<li role="option" id="cog-21-state-option-Puerto Rico" aria-selected="false" class="el-select-dropdown__item" style="order: 45;"><span>Puerto Rico</span></li>
<li role="option" id="cog-21-state-option-Rhode Island" aria-selected="false" class="el-select-dropdown__item" style="order: 46;"><span>Rhode Island</span></li>
<li role="option" id="cog-21-state-option-South Carolina" aria-selected="false" class="el-select-dropdown__item" style="order: 47;"><span>South Carolina</span></li>
<li role="option" id="cog-21-state-option-South Dakota" aria-selected="false" class="el-select-dropdown__item" style="order: 48;"><span>South Dakota</span></li>
<li role="option" id="cog-21-state-option-Tennessee" aria-selected="false" class="el-select-dropdown__item" style="order: 49;"><span>Tennessee</span></li>
<li role="option" id="cog-21-state-option-Texas" aria-selected="false" class="el-select-dropdown__item" style="order: 50;"><span>Texas</span></li>
<li role="option" id="cog-21-state-option-Utah" aria-selected="false" class="el-select-dropdown__item" style="order: 51;"><span>Utah</span></li>
<li role="option" id="cog-21-state-option-Vermont" aria-selected="false" class="el-select-dropdown__item" style="order: 52;"><span>Vermont</span></li>
<li role="option" id="cog-21-state-option-Virgin Islands" aria-selected="false" class="el-select-dropdown__item" style="order: 53;"><span>Virgin Islands</span></li>
<li role="option" id="cog-21-state-option-Virginia" aria-selected="false" class="el-select-dropdown__item" style="order: 54;"><span>Virginia</span></li>
<li role="option" id="cog-21-state-option-Washington" aria-selected="false" class="el-select-dropdown__item" style="order: 55;"><span>Washington</span></li>
<li role="option" id="cog-21-state-option-West Virginia" aria-selected="false" class="el-select-dropdown__item" style="order: 56;"><span>West Virginia</span></li>
<li role="option" id="cog-21-state-option-Wisconsin" aria-selected="false" class="el-select-dropdown__item" style="order: 57;"><span>Wisconsin</span></li>
<li role="option" id="cog-21-state-option-Wyoming" aria-selected="false" class="el-select-dropdown__item" style="order: 58;"><span>Wyoming</span></li>
</ul>
</div><!----><!---->
</div><!---->
</div>
</div>
</div> <!---->
<div class="cog-input cog-address__postal-code cog-input--medium">
<div class="el-input"><!----><input type="text" autocomplete="postal-code" id="cog-21-zip-code" placeholder="Zip Code" title="Zip Code" class="el-input__inner"><!----><!----><!----><!----></div>
</div> <!----> <!---->
</div>
</div>
<div class="cog-field__placeholder cog-input">
<div class="cog-field__placeholder-inner"> </div>
</div> <!----> <!----> <!---->
</fieldset>
</div>
<div class="cog-row">
<div class="cog-field cog-field--9 cog-col cog-col--6 cog-text cog-text--singleline is-required"><label id="cog-22-label" for="cog-22" class="cog-label"> SSN:<span aria-hidden="true" class="cog-asterisk">*</span> <span
class="cog-offscreen">(required)</span> <!----></label>
<div class="cog-input">
<div class="el-input"><!----><input type="text" autocomplete="off" id="cog-22" placeholder="" class="el-input__inner"><!----><!----><!----><!----></div>
</div>
<div class="cog-field__placeholder cog-input">
<div class="cog-field__placeholder-inner"> </div>
</div> <!----> <!----> <!---->
</div>
<div class="cog-field cog-field--6 cog-col cog-col--6 cog-date cog-date--date is-required"><label id="cog-23-label" for="cog-23" class="cog-label"> Date of Birth:<span aria-hidden="true" class="cog-asterisk">*</span> <span
class="cog-offscreen">(required)</span> <!----></label>
<div class="cog-picker cog-input">
<div class="el-date-editor el-input el-input--prefix el-input--suffix el-date-editor--date"><!----><input type="text" autocomplete="off" name="" id="cog-23" class="el-input__inner"><span class="el-input__prefix"><span><svg
viewBox="0 0 18 18" focusable="false" class="cog-icon cog-i-calendar">
<defs></defs>
<g>
<path d="M2.5 3.5h13v12h-13z"></path>
<path d="M4.02 7.5h9.88" class="cog-i-calendar__rule"></path>
<path d="M5.5 5V1.5M12.5 5V1.5"></path>
</g>
</svg></span><!----></span><span class="el-input__suffix"><span class="el-input__suffix-inner"><i class="el-input__icon"></i><!----><!----><!----><!----></span><!----></span><!----><!----></div>
</div>
<div class="cog-field__placeholder cog-input">
<div class="cog-field__placeholder-inner"> </div>
</div> <!----> <!----> <!---->
</div>
<div class="cog-field cog-field--7 cog-col cog-col--6 cog-phone cog-phone--us is-required"><label id="cog-24-label" for="cog-24" class="cog-label"> Phone #:<span aria-hidden="true" class="cog-asterisk">*</span> <span
class="cog-offscreen">(required)</span> <!----></label>
<div class="cog-input">
<div class="el-input"><!----><input type="text" autocomplete="tel-national" id="cog-24" placeholder="" class="el-input__inner"><!----><!----><!----><!----></div>
</div>
<div class="cog-field__placeholder cog-input">
<div class="cog-field__placeholder-inner"> </div>
</div> <!----> <!----> <!---->
</div>
<div class="cog-field cog-field--8 cog-col cog-col--6 cog-number cog-number--integer is-required"><label id="cog-25-label" for="cog-25" class="cog-label"> Personal Credit Score:<span aria-hidden="true" class="cog-asterisk">*</span>
<span class="cog-offscreen">(required)</span> <!----></label>
<div class="cog-input">
<div class="el-input"><!----><input type="text" autocomplete="off" id="cog-25" placeholder="" inputmode="" class="el-input__inner"><!----><!----><!----><!----></div>
</div>
<div class="cog-field__placeholder cog-input">
<div class="cog-field__placeholder-inner"> </div>
</div> <!----> <!----> <!---->
</div>
</div>
</div> <!---->
</section>
</div>
<div class="cog-row">
<section aria-labelledby="cog-26" tabindex="-1" class="cog-section cog-col cog-col--24 cog-section--heading cog-field--14">
<div class="cog-section__inner cog-section__inner--no-background ">
<h2 id="cog-26" class="cog-section__heading cog-heading"> PARTNER INFORMATION <!----></h2> <!---->
<div class="cog-row">
<div class="cog-field cog-field--1 cog-col cog-col--8 cog-text cog-text--singleline"><label id="cog-27-label" for="cog-27" class="cog-label"> Partner Name:<!----> <!----> <!----></label>
<div class="cog-input">
<div class="el-input"><!----><input type="text" autocomplete="off" id="cog-27" placeholder="" class="el-input__inner"><!----><!----><!----><!----></div>
</div>
<div class="cog-field__placeholder cog-input">
<div class="cog-field__placeholder-inner"> </div>
</div> <!----> <!----> <!---->
</div>
<div class="cog-field cog-field--2 cog-col cog-col--8 cog-text cog-text--singleline"><label id="cog-28-label" for="cog-28" class="cog-label"> Title:<!----> <!----> <!----></label>
<div class="cog-input">
<div class="el-input"><!----><input type="text" autocomplete="off" id="cog-28" placeholder="" class="el-input__inner"><!----><!----><!----><!----></div>
</div>
<div class="cog-field__placeholder cog-input">
<div class="cog-field__placeholder-inner"> </div>
</div> <!----> <!----> <!---->
</div>
<div class="cog-field cog-field--3 cog-col cog-col--8 cog-number cog-number--percent"><label id="cog-29-label" for="cog-29" class="cog-label"> Ownership %:<!----> <!----> <!----></label>
<div class="cog-input">
<div class="el-input"><!----><input type="text" autocomplete="off" id="cog-29" placeholder="" inputmode="" class="el-input__inner"><!----><!----><!----><!----></div>
</div>
<div class="cog-field__placeholder cog-input">
<div class="cog-field__placeholder-inner"> </div>
</div> <!----> <!----> <!---->
</div>
</div>
<div class="cog-row">
<fieldset class="cog-field cog-field--4 cog-col cog-col--24 cog-address cog-address--us">
<legend class="cog-label"> Home Address:<!----> <!----> <!----></legend>
<div class="cog-address">
<div class="cog-row">
<div class="cog-input cog-address__street cog-input--full">
<div class="el-input"><!----><input type="text" autocomplete="address-line1" id="cog-30-line1" placeholder="Address Line 1" title="Address Line 1" class="el-input__inner"><!----><!----><!----><!----></div>
</div>
<div class="cog-input cog-address__line-2 cog-input--full">
<div class="el-input"><!----><input type="text" autocomplete="address-line2" id="cog-30-line2" placeholder="Address Line 2" title="Address Line 2" class="el-input__inner"><!----><!----><!----><!----></div>
</div> <!---->
<div class="cog-input cog-address__city cog-input--long">
<div class="el-input"><!----><input type="text" autocomplete="address-level2" id="cog-30-city" placeholder="City" title="City" class="el-input__inner"><!----><!----><!----><!----></div>
</div>
<div class="cog-picker cog-select cog-input cog-address__state cog-input--long">
<div class="el-select el-select--dropdown-bottom"><!---->
<div class="el-input el-input--prefix el-input--suffix"><!----><input type="text" autocomplete="address-level1" placeholder="State" title="State" id="cog-30-state" aria-controls="cog-30-state-listbox" role="combobox"
aria-haspopup="listbox" aria-owns="cog-30-state-listbox" aria-expanded="false" class="el-input__inner" aria-activedescendant="cog-30-state-option-null" style="height: 34.8906px;"><span
class="el-input__prefix"><span><svg viewBox="0 0 18 18" focusable="false" class="cog-icon cog-i-chevron">
<g>
<path stroke-linecap="square" d="M3 7l6 6 6-6"></path>
</g>
</svg></span><!----></span><span class="el-input__suffix"><span
class="el-input__suffix-inner"><!----><i class="el-select__caret el-input__icon el-icon-arrow-up"></i><!----><!----><!----><!----><!----></span><!----></span><!----><!----></div>
<div class="el-select-dropdown el-popper cog-cognito cog-1 cog-cognito--styled cog-select-popper " style="display: none; min-width: 283.281px;">
<div class="el-scrollbar" style="">
<div class="el-select-dropdown__wrap el-scrollbar__wrap el-scrollbar__wrap--hidden-default">
<ul id="cog-30-state-listbox" role="listbox" class="el-scrollbar__view el-select-dropdown__list"><!---->
<li role="option" id="cog-30-state-option-null" aria-selected="true" class="el-select-dropdown__item cog-select-option--empty selected hover"> </li>
<li role="option" id="cog-30-state-option-Armed Forces America" aria-selected="false" class="el-select-dropdown__item" style="order: 0;"><span>Armed Forces America</span></li>
<li role="option" id="cog-30-state-option-Armed Forces" aria-selected="false" class="el-select-dropdown__item" style="order: 1;"><span>Armed Forces</span></li>
<li role="option" id="cog-30-state-option-Armed Forces Pacific" aria-selected="false" class="el-select-dropdown__item" style="order: 2;"><span>Armed Forces Pacific</span></li>
<li role="option" id="cog-30-state-option-Alabama" aria-selected="false" class="el-select-dropdown__item" style="order: 3;"><span>Alabama</span></li>
<li role="option" id="cog-30-state-option-Alaska" aria-selected="false" class="el-select-dropdown__item" style="order: 4;"><span>Alaska</span></li>
<li role="option" id="cog-30-state-option-American Samoa" aria-selected="false" class="el-select-dropdown__item" style="order: 5;"><span>American Samoa</span></li>
<li role="option" id="cog-30-state-option-Arizona" aria-selected="false" class="el-select-dropdown__item" style="order: 6;"><span>Arizona</span></li>
<li role="option" id="cog-30-state-option-Arkansas" aria-selected="false" class="el-select-dropdown__item" style="order: 7;"><span>Arkansas</span></li>
<li role="option" id="cog-30-state-option-California" aria-selected="false" class="el-select-dropdown__item" style="order: 8;"><span>California</span></li>
<li role="option" id="cog-30-state-option-Colorado" aria-selected="false" class="el-select-dropdown__item" style="order: 9;"><span>Colorado</span></li>
<li role="option" id="cog-30-state-option-Connecticut" aria-selected="false" class="el-select-dropdown__item" style="order: 10;"><span>Connecticut</span></li>
<li role="option" id="cog-30-state-option-Delaware" aria-selected="false" class="el-select-dropdown__item" style="order: 11;"><span>Delaware</span></li>
<li role="option" id="cog-30-state-option-District of Columbia" aria-selected="false" class="el-select-dropdown__item" style="order: 12;"><span>District of Columbia</span></li>
<li role="option" id="cog-30-state-option-Florida" aria-selected="false" class="el-select-dropdown__item" style="order: 13;"><span>Florida</span></li>
<li role="option" id="cog-30-state-option-Georgia" aria-selected="false" class="el-select-dropdown__item" style="order: 14;"><span>Georgia</span></li>
<li role="option" id="cog-30-state-option-Guam" aria-selected="false" class="el-select-dropdown__item" style="order: 15;"><span>Guam</span></li>
<li role="option" id="cog-30-state-option-Hawaii" aria-selected="false" class="el-select-dropdown__item" style="order: 16;"><span>Hawaii</span></li>
<li role="option" id="cog-30-state-option-Idaho" aria-selected="false" class="el-select-dropdown__item" style="order: 17;"><span>Idaho</span></li>
<li role="option" id="cog-30-state-option-Illinois" aria-selected="false" class="el-select-dropdown__item" style="order: 18;"><span>Illinois</span></li>
<li role="option" id="cog-30-state-option-Indiana" aria-selected="false" class="el-select-dropdown__item" style="order: 19;"><span>Indiana</span></li>
<li role="option" id="cog-30-state-option-Iowa" aria-selected="false" class="el-select-dropdown__item" style="order: 20;"><span>Iowa</span></li>
<li role="option" id="cog-30-state-option-Kansas" aria-selected="false" class="el-select-dropdown__item" style="order: 21;"><span>Kansas</span></li>
<li role="option" id="cog-30-state-option-Kentucky" aria-selected="false" class="el-select-dropdown__item" style="order: 22;"><span>Kentucky</span></li>
<li role="option" id="cog-30-state-option-Louisiana" aria-selected="false" class="el-select-dropdown__item" style="order: 23;"><span>Louisiana</span></li>
<li role="option" id="cog-30-state-option-Maine" aria-selected="false" class="el-select-dropdown__item" style="order: 24;"><span>Maine</span></li>
<li role="option" id="cog-30-state-option-Maryland" aria-selected="false" class="el-select-dropdown__item" style="order: 25;"><span>Maryland</span></li>
<li role="option" id="cog-30-state-option-Massachusetts" aria-selected="false" class="el-select-dropdown__item" style="order: 26;"><span>Massachusetts</span></li>
<li role="option" id="cog-30-state-option-Michigan" aria-selected="false" class="el-select-dropdown__item" style="order: 27;"><span>Michigan</span></li>
<li role="option" id="cog-30-state-option-Minnesota" aria-selected="false" class="el-select-dropdown__item" style="order: 28;"><span>Minnesota</span></li>
<li role="option" id="cog-30-state-option-Mississippi" aria-selected="false" class="el-select-dropdown__item" style="order: 29;"><span>Mississippi</span></li>
<li role="option" id="cog-30-state-option-Missouri" aria-selected="false" class="el-select-dropdown__item" style="order: 30;"><span>Missouri</span></li>
<li role="option" id="cog-30-state-option-Montana" aria-selected="false" class="el-select-dropdown__item" style="order: 31;"><span>Montana</span></li>
<li role="option" id="cog-30-state-option-Nebraska" aria-selected="false" class="el-select-dropdown__item" style="order: 32;"><span>Nebraska</span></li>
<li role="option" id="cog-30-state-option-Nevada" aria-selected="false" class="el-select-dropdown__item" style="order: 33;"><span>Nevada</span></li>
<li role="option" id="cog-30-state-option-New Hampshire" aria-selected="false" class="el-select-dropdown__item" style="order: 34;"><span>New Hampshire</span></li>
<li role="option" id="cog-30-state-option-New Jersey" aria-selected="false" class="el-select-dropdown__item" style="order: 35;"><span>New Jersey</span></li>
<li role="option" id="cog-30-state-option-New Mexico" aria-selected="false" class="el-select-dropdown__item" style="order: 36;"><span>New Mexico</span></li>
<li role="option" id="cog-30-state-option-New York" aria-selected="false" class="el-select-dropdown__item" style="order: 37;"><span>New York</span></li>
<li role="option" id="cog-30-state-option-North Carolina" aria-selected="false" class="el-select-dropdown__item" style="order: 38;"><span>North Carolina</span></li>
<li role="option" id="cog-30-state-option-North Dakota" aria-selected="false" class="el-select-dropdown__item" style="order: 39;"><span>North Dakota</span></li>
<li role="option" id="cog-30-state-option-Northern Mariana Islands" aria-selected="false" class="el-select-dropdown__item" style="order: 40;"><span>Northern Mariana Islands</span></li>
<li role="option" id="cog-30-state-option-Ohio" aria-selected="false" class="el-select-dropdown__item" style="order: 41;"><span>Ohio</span></li>
<li role="option" id="cog-30-state-option-Oklahoma" aria-selected="false" class="el-select-dropdown__item" style="order: 42;"><span>Oklahoma</span></li>
<li role="option" id="cog-30-state-option-Oregon" aria-selected="false" class="el-select-dropdown__item" style="order: 43;"><span>Oregon</span></li>
<li role="option" id="cog-30-state-option-Pennsylvania" aria-selected="false" class="el-select-dropdown__item" style="order: 44;"><span>Pennsylvania</span></li>
<li role="option" id="cog-30-state-option-Puerto Rico" aria-selected="false" class="el-select-dropdown__item" style="order: 45;"><span>Puerto Rico</span></li>
<li role="option" id="cog-30-state-option-Rhode Island" aria-selected="false" class="el-select-dropdown__item" style="order: 46;"><span>Rhode Island</span></li>
<li role="option" id="cog-30-state-option-South Carolina" aria-selected="false" class="el-select-dropdown__item" style="order: 47;"><span>South Carolina</span></li>
<li role="option" id="cog-30-state-option-South Dakota" aria-selected="false" class="el-select-dropdown__item" style="order: 48;"><span>South Dakota</span></li>
<li role="option" id="cog-30-state-option-Tennessee" aria-selected="false" class="el-select-dropdown__item" style="order: 49;"><span>Tennessee</span></li>
<li role="option" id="cog-30-state-option-Texas" aria-selected="false" class="el-select-dropdown__item" style="order: 50;"><span>Texas</span></li>
<li role="option" id="cog-30-state-option-Utah" aria-selected="false" class="el-select-dropdown__item" style="order: 51;"><span>Utah</span></li>
<li role="option" id="cog-30-state-option-Vermont" aria-selected="false" class="el-select-dropdown__item" style="order: 52;"><span>Vermont</span></li>
<li role="option" id="cog-30-state-option-Virgin Islands" aria-selected="false" class="el-select-dropdown__item" style="order: 53;"><span>Virgin Islands</span></li>
<li role="option" id="cog-30-state-option-Virginia" aria-selected="false" class="el-select-dropdown__item" style="order: 54;"><span>Virginia</span></li>
<li role="option" id="cog-30-state-option-Washington" aria-selected="false" class="el-select-dropdown__item" style="order: 55;"><span>Washington</span></li>
<li role="option" id="cog-30-state-option-West Virginia" aria-selected="false" class="el-select-dropdown__item" style="order: 56;"><span>West Virginia</span></li>
<li role="option" id="cog-30-state-option-Wisconsin" aria-selected="false" class="el-select-dropdown__item" style="order: 57;"><span>Wisconsin</span></li>
<li role="option" id="cog-30-state-option-Wyoming" aria-selected="false" class="el-select-dropdown__item" style="order: 58;"><span>Wyoming</span></li>
</ul>
</div><!----><!---->
</div><!---->
</div>
</div>
</div> <!---->
<div class="cog-input cog-address__postal-code cog-input--medium">
<div class="el-input"><!----><input type="text" autocomplete="postal-code" id="cog-30-zip-code" placeholder="Zip Code" title="Zip Code" class="el-input__inner"><!----><!----><!----><!----></div>
</div> <!----> <!---->
</div>
</div>
<div class="cog-field__placeholder cog-input">
<div class="cog-field__placeholder-inner"> </div>
</div> <!----> <!----> <!---->
</fieldset>
</div>
<div class="cog-row">
<div class="cog-field cog-field--25 cog-col cog-col--6 cog-text cog-text--singleline"><label id="cog-31-label" for="cog-31" class="cog-label"> SSN:<!----> <!----> <!----></label>
<div class="cog-input">
<div class="el-input"><!----><input type="text" autocomplete="off" id="cog-31" placeholder="" class="el-input__inner"><!----><!----><!----><!----></div>
</div>
<div class="cog-field__placeholder cog-input">
<div class="cog-field__placeholder-inner"> </div>
</div> <!----> <!----> <!---->
</div>
<div class="cog-field cog-field--6 cog-col cog-col--6 cog-date cog-date--date"><label id="cog-32-label" for="cog-32" class="cog-label"> Date of Birth:<!----> <!----> <!----></label>
<div class="cog-picker cog-input">
<div class="el-date-editor el-input el-input--prefix el-input--suffix el-date-editor--date"><!----><input type="text" autocomplete="off" name="" id="cog-32" class="el-input__inner"><span class="el-input__prefix"><span><svg
viewBox="0 0 18 18" focusable="false" class="cog-icon cog-i-calendar">
<defs></defs>
<g>
<path d="M2.5 3.5h13v12h-13z"></path>
<path d="M4.02 7.5h9.88" class="cog-i-calendar__rule"></path>
<path d="M5.5 5V1.5M12.5 5V1.5"></path>
</g>
</svg></span><!----></span><span class="el-input__suffix"><span class="el-input__suffix-inner"><i class="el-input__icon"></i><!----><!----><!----><!----></span><!----></span><!----><!----></div>
</div>
<div class="cog-field__placeholder cog-input">
<div class="cog-field__placeholder-inner"> </div>
</div> <!----> <!----> <!---->
</div>
<div class="cog-field cog-field--7 cog-col cog-col--6 cog-phone cog-phone--us"><label id="cog-33-label" for="cog-33" class="cog-label"> Phone #:<!----> <!----> <!----></label>
<div class="cog-input">
<div class="el-input"><!----><input type="text" autocomplete="tel-national" id="cog-33" placeholder="" class="el-input__inner"><!----><!----><!----><!----></div>
</div>
<div class="cog-field__placeholder cog-input">
<div class="cog-field__placeholder-inner"> </div>
</div> <!----> <!----> <!---->
</div>
<div class="cog-field cog-field--8 cog-col cog-col--6 cog-number cog-number--integer"><label id="cog-34-label" for="cog-34" class="cog-label"> Personal Credit Score:<!----> <!----> <!----></label>
<div class="cog-input">
<div class="el-input"><!----><input type="text" autocomplete="off" id="cog-34" placeholder="" inputmode="" class="el-input__inner"><!----><!----><!----><!----></div>
</div>
<div class="cog-field__placeholder cog-input">
<div class="cog-field__placeholder-inner"> </div>
</div> <!----> <!----> <!---->
</div>
</div>
</div> <!---->
</section>
</div>
<div class="cog-row">
<fieldset class="cog-field cog-field--17 cog-col cog-col--24 cog-choice cog-choice--checkboxes is-required">
<legend class="cog-label cog-offscreen"> Applicant consent authorization<span aria-hidden="true" class="cog-asterisk">*</span> <span class="cog-offscreen">(required)</span> <!----></legend>
<div class="cog-choice">
<div class="cog-checkable cog-input cog-inner-col cog-inner-col--no-css-columns cog-inner-col--1">
<div aria-label="checkbox-group" class="el-checkbox-group"><label class="el-checkbox cog-checkable__item cog-inner-col__item" style="order: 0;"><span class="el-checkbox__input"><span class="el-checkbox__inner"></span><input
type="checkbox" class="el-checkbox__original"
value="By ticking the box and clicking the submit button, I hereby authorize Sterling Financial, its assigns, agents, banks or financial institutions to obtain an investigative or consumer report from a credit bureau or a credit agency and to investigate the references given on any other statement or data obtained from applicant."></span><span
class="el-checkbox__label"> By ticking the box and clicking the submit button, I hereby authorize Sterling Financial, its assigns, agents, banks or financial institutions to obtain an investigative or consumer report from a
credit bureau or a credit agency and to investigate the references given on any other statement or data obtained from applicant. <!----></span></label> <!----></div>
</div>
<div class="cog-choice__placeholder cog-inner-col cog-inner-col--css-columns cog-inner-col--1">
<div>
<div class="cog-choice__checkable-placeholder cog-inner-col__item"><span>By ticking the box and clicking the submit button, I hereby authorize Sterling Financial, its assigns, agents, banks or financial institutions to obtain an
investigative or consumer report from a credit bureau or a credit agency and to investigate the references given on any other statement or data obtained from applicant.</span></div> <!---->
</div>
</div>
</div>
<div class="cog-field__placeholder cog-input">
<div class="cog-field__placeholder-inner"> </div>
</div> <!----> <!----> <!---->
</fieldset>
</div>
<div class="cog-row">
<div class="cog-field cog-field--18 cog-col cog-col--18 cog-signature is-required"><label id="cog-1-label" for="cog-1" class="cog-label"> Applicant’s Signature<span aria-hidden="true" class="cog-asterisk">*</span> <span
class="cog-offscreen">(required)</span> <!----></label>
<div class="cog-input cog-signature cog-signature--draw">
<div class="cog-signature__pad">
<div class="cog-field__placeholder">
<div class="cog-field__placeholder-inner"> <svg viewBox="0 0 18 18" focusable="false" class="cog-icon cog-i-cog">
<g>
<path
d="M15.5 9.8V8.17l-1.83-.32a5.21 5.21 0 00-.56-1.33L14.16 5 13 3.83l-1.52 1.08a8.28 8.28 0 00-1.32-.54L9.82 2.5H8.19l-.34 1.87a4.87 4.87 0 00-1.3.53L5 3.84 3.87 4.92l1 1.64a4.53 4.53 0 00-.54 1.31L2.5 8.2v1.64l1.86.34a5 5 0 00.55 1.3L3.87 13 5 14.19l1.54-1.06a4.89 4.89 0 001.31.56l.33 1.81h1.63l.33-1.86a5.38 5.38 0 001.34-.54L13 14.15 14.16 13l-1.06-1.53a5.46 5.46 0 00.57-1.34zM9 11a2 2 0 112-2 2 2 0 01-2 2z">
</path>
</g>
</svg></div>
</div> <img src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAABCAQAAAC1HAwCAAAAC0lEQVR42mNkYAAAAAYAAjCB0C8AAAAASUVORK5CYII=" class="canvas-png cog-offscreen">
<div tabindex="-1" class="cog-signature__canvas-container"><canvas width="1072" height="500" style="touch-action: none; user-select: none;"></canvas></div> <!----> <canvas class="cog-signature__text-canvas" width="1072"
height="500"></canvas> <input id="cog-1" tabindex="-1" type="text" spellcheck="false" autocomplete="off" class="cog-signature__keyboard-input"
style="font-size: 71px; font-family: "Mrs Saint Delafield", "Segoe Script", "Bradley Hand ITC", "Brush Script MT", cursive; color: rgb(51, 51, 51); display: none;">
<div class="cog-signature__symbol"><span aria-hidden="true" class="cog-signature__write-symbol">×</span></div>
</div>
<div class="cog-signature__toggle-buttons"><span tabindex="-1" class="cog-offscreen"></span> <button type="button" class="el-button el-button--default cog-button--no-style" tabindex="-1" disabled="disabled"><!----><!----><span><!---->
draw <!----> </span></button> <button type="button" class="el-button el-button--default cog-button--no-style" aria-labelledby="cog-1-label" aria-controls="cog-1"><!----><!----><span><!----> type <!----> </span></button></div>
</div>
<div class="cog-field__placeholder cog-input">
<div class="cog-field__placeholder-inner"> </div>
</div> <!----> <!----> <!---->
</div>
<div class="cog-field cog-field--19 cog-col cog-col--6 cog-date cog-date--date is-required"><label id="cog-2-label" for="cog-2" class="cog-label"> Date<span aria-hidden="true" class="cog-asterisk">*</span> <span
class="cog-offscreen">(required)</span> <!----></label>
<div class="cog-picker cog-input">
<div class="el-date-editor el-input el-input--prefix el-input--suffix el-date-editor--date"><!----><input type="text" autocomplete="off" name="" id="cog-2" class="el-input__inner"><span class="el-input__prefix"><span><svg
viewBox="0 0 18 18" focusable="false" class="cog-icon cog-i-calendar">
<defs></defs>
<g>
<path d="M2.5 3.5h13v12h-13z"></path>
<path d="M4.02 7.5h9.88" class="cog-i-calendar__rule"></path>
<path d="M5.5 5V1.5M12.5 5V1.5"></path>
</g>
</svg></span><!----></span><span class="el-input__suffix"><span class="el-input__suffix-inner"><i class="el-input__icon"></i><!----><!----><!----><!----></span><!----></span><!----><!----></div>
</div>
<div class="cog-field__placeholder cog-input">
<div class="cog-field__placeholder-inner"> </div>
</div> <!----> <!----> <!---->
</div>
</div>
<div class="cog-row">
<div class="cog-field cog-field--22 cog-col cog-col--18 cog-signature"><label id="cog-3-label" for="cog-3" class="cog-label"> Partner's Signature<!----> <!----> <!----></label>
<div class="cog-input cog-signature cog-signature--draw">
<div class="cog-signature__pad">
<div class="cog-field__placeholder">
<div class="cog-field__placeholder-inner"> <svg viewBox="0 0 18 18" focusable="false" class="cog-icon cog-i-cog">
<g>
<path
d="M15.5 9.8V8.17l-1.83-.32a5.21 5.21 0 00-.56-1.33L14.16 5 13 3.83l-1.52 1.08a8.28 8.28 0 00-1.32-.54L9.82 2.5H8.19l-.34 1.87a4.87 4.87 0 00-1.3.53L5 3.84 3.87 4.92l1 1.64a4.53 4.53 0 00-.54 1.31L2.5 8.2v1.64l1.86.34a5 5 0 00.55 1.3L3.87 13 5 14.19l1.54-1.06a4.89 4.89 0 001.31.56l.33 1.81h1.63l.33-1.86a5.38 5.38 0 001.34-.54L13 14.15 14.16 13l-1.06-1.53a5.46 5.46 0 00.57-1.34zM9 11a2 2 0 112-2 2 2 0 01-2 2z">
</path>
</g>
</svg></div>
</div> <img src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAABCAQAAAC1HAwCAAAAC0lEQVR42mNkYAAAAAYAAjCB0C8AAAAASUVORK5CYII=" class="canvas-png cog-offscreen">
<div tabindex="-1" class="cog-signature__canvas-container"><canvas width="1072" height="500" style="touch-action: none; user-select: none;"></canvas></div> <!----> <canvas class="cog-signature__text-canvas" width="1072"
height="500"></canvas> <input id="cog-3" tabindex="-1" type="text" spellcheck="false" autocomplete="off" class="cog-signature__keyboard-input"
style="font-size: 71px; font-family: "Mrs Saint Delafield", "Segoe Script", "Bradley Hand ITC", "Brush Script MT", cursive; color: rgb(51, 51, 51); display: none;">
<div class="cog-signature__symbol"><span aria-hidden="true" class="cog-signature__write-symbol">×</span></div>
</div>
<div class="cog-signature__toggle-buttons"><span tabindex="-1" class="cog-offscreen"></span> <button type="button" class="el-button el-button--default cog-button--no-style" tabindex="-1" disabled="disabled"><!----><!----><span><!---->
draw <!----> </span></button> <button type="button" class="el-button el-button--default cog-button--no-style" aria-labelledby="cog-3-label" aria-controls="cog-3"><!----><!----><span><!----> type <!----> </span></button></div>
</div>
<div class="cog-field__placeholder cog-input">
<div class="cog-field__placeholder-inner"> </div>
</div> <!----> <!----> <!---->
</div>
<div class="cog-field cog-field--23 cog-col cog-col--6 cog-date cog-date--date"><label id="cog-4-label" for="cog-4" class="cog-label"> Date<!----> <!----> <!----></label>
<div class="cog-picker cog-input">
<div class="el-date-editor el-input el-input--prefix el-input--suffix el-date-editor--date"><!----><input type="text" autocomplete="off" name="" id="cog-4" class="el-input__inner"><span class="el-input__prefix"><span><svg
viewBox="0 0 18 18" focusable="false" class="cog-icon cog-i-calendar">
<defs></defs>
<g>
<path d="M2.5 3.5h13v12h-13z"></path>
<path d="M4.02 7.5h9.88" class="cog-i-calendar__rule"></path>
<path d="M5.5 5V1.5M12.5 5V1.5"></path>
</g>
</svg></span><!----></span><span class="el-input__suffix"><span class="el-input__suffix-inner"><i class="el-input__icon"></i><!----><!----><!----><!----></span><!----></span><!----><!----></div>
</div>
<div class="cog-field__placeholder cog-input">
<div class="cog-field__placeholder-inner"> </div>
</div> <!----> <!----> <!---->
</div>
</div>
<div class="cog-row">
<div class="cog-field cog-field--21 cog-col cog-col--24 cog-file"><label id="cog-5-label" for="cog-5" class="cog-label"> Upload business bank statements for the last three (3) months.<!----> <!----> <!----></label>
<div class="cog-input">
<div class="cog-upload">
<div>
<div tabindex="-1" class="el-upload el-upload--picture">
<div class="el-upload-dragger">
<div><button type="button" class="el-button cog-button--secondary cog-upload__upload-button el-button--default cog-button"><!----><!----><span><!----> <span class="cog-button__text"> Upload </span> <!----> </span></button>
<span class="cog-upload__drag-text">or drag files here.</span></div>
</div><input type="file" name="file" multiple="multiple" class="el-upload__input">
</div>
</div>
<ul class="cog-upload__list"></ul> <!----> <iframe id="cog-download-frame" style="display: none;"></iframe>
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<div class="cog-field__placeholder cog-input">
<div class="cog-field__placeholder-inner"> </div>
</div> <!----> <!----> <!---->
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<div class="cog-row" style="display: none;">
<div class="cog-field cog-col cog-col--12"><!----></div>
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<div class="cog-page__navigation"><!----> <button type="submit" class="el-button cog-button--has-status cog-button--primary cog-button--navigation cog-button--submit el-button--default cog-button" data-next=""
data-action-name="Submit"><!----><!----><span><!----> <span class="cog-button__text"> Submit </span> <!----> </span></button> <button type="button"
class="el-button cog-button--has-status cog-button--save cog-button--secondary cog-button--navigation el-button--default cog-button"><!----><!----><span><!----> <span class="cog-button__text"> Save</span> <!----> </span></button></div>
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</div>
</div>
<div tabindex="0" class="cog-dialog cog-save-resume-dialog" emailmessage="">
<div class="el-dialog__wrapper" style="display: none;">
<div role="dialog" aria-modal="true" aria-label="dialog" class="el-dialog" style="margin-top: 15vh;">
<div class="el-dialog__header"><span class="el-dialog__title"></span><button type="button" aria-label="Close" class="el-dialog__headerbtn" title="Close"><i class="el-dialog__close el-icon el-icon-close"></i><svg viewBox="0 0 18 18"
focusable="false" class="cog-icon cog-i-ex">
<defs></defs>
<g>
<path d="M4.2 4.2l9.6 9.6M13.8 4.2l-9.6 9.6"></path>
</g>
</svg></button></div><!----><!---->
</div>
</div>
</div><!----><!---->
</div>
</div>
</form>Text Content
BUSINESS FINANCING APPLICATION BUSINESS INFORMATION Legal/ Corporate NameName:* (required)  DBA:* (required)  Physical Address:* (required) *  * Armed Forces America * Armed Forces * Armed Forces Pacific * Alabama * Alaska * American Samoa * Arizona * Arkansas * California * Colorado * Connecticut * Delaware * District of Columbia * Florida * Georgia * Guam * Hawaii * Idaho * Illinois * Indiana * Iowa * Kansas * Kentucky * Louisiana * Maine * Maryland * Massachusetts * Michigan * Minnesota * Mississippi * Missouri * Montana * Nebraska * Nevada * New Hampshire * New Jersey * New Mexico * New York * North Carolina * North Dakota * Northern Mariana Islands * Ohio * Oklahoma * Oregon * Pennsylvania * Puerto Rico * Rhode Island * South Carolina * South Dakota * Tennessee * Texas * Utah * Vermont * Virgin Islands * Virginia * Washington * West Virginia * Wisconsin * Wyoming  Telephone #:* (required)  Date Business Started:  Federal Tax ID:* (required)  Type of Entity (check one):* (required) Sole Proprietorship Partnership Corporation LLC Other Sole Proprietorship Partnership Corporation LLC Other  Email Address:* (required)  Type of Business (check all that apply):* (required) Retail Wholesale Construction Transportation Other Retail Wholesale Construction Transportation Other  Product/ Service Sold:* (required)  MERCHANT/OWNER INFORMATION Corporate Officer / Owner Name:* (required)  Title:* (required)  Ownership %:* (required)  Home Address:* (required) *  * Armed Forces America * Armed Forces * Armed Forces Pacific * Alabama * Alaska * American Samoa * Arizona * Arkansas * California * Colorado * Connecticut * Delaware * District of Columbia * Florida * Georgia * Guam * Hawaii * Idaho * Illinois * Indiana * Iowa * Kansas * Kentucky * Louisiana * Maine * Maryland * Massachusetts * Michigan * Minnesota * Mississippi * Missouri * Montana * Nebraska * Nevada * New Hampshire * New Jersey * New Mexico * New York * North Carolina * North Dakota * Northern Mariana Islands * Ohio * Oklahoma * Oregon * Pennsylvania * Puerto Rico * Rhode Island * South Carolina * South Dakota * Tennessee * Texas * Utah * Vermont * Virgin Islands * Virginia * Washington * West Virginia * Wisconsin * Wyoming  SSN:* (required)  Date of Birth:* (required)  Phone #:* (required)  Personal Credit Score:* (required)  PARTNER INFORMATION Partner Name:  Title:  Ownership %:  Home Address: *  * Armed Forces America * Armed Forces * Armed Forces Pacific * Alabama * Alaska * American Samoa * Arizona * Arkansas * California * Colorado * Connecticut * Delaware * District of Columbia * Florida * Georgia * Guam * Hawaii * Idaho * Illinois * Indiana * Iowa * Kansas * Kentucky * Louisiana * Maine * Maryland * Massachusetts * Michigan * Minnesota * Mississippi * Missouri * Montana * Nebraska * Nevada * New Hampshire * New Jersey * New Mexico * New York * North Carolina * North Dakota * Northern Mariana Islands * Ohio * Oklahoma * Oregon * Pennsylvania * Puerto Rico * Rhode Island * South Carolina * South Dakota * Tennessee * Texas * Utah * Vermont * Virgin Islands * Virginia * Washington * West Virginia * Wisconsin * Wyoming  SSN:  Date of Birth:  Phone #:  Personal Credit Score:  Applicant consent authorization* (required) By ticking the box and clicking the submit button, I hereby authorize Sterling Financial, its assigns, agents, banks or financial institutions to obtain an investigative or consumer report from a credit bureau or a credit agency and to investigate the references given on any other statement or data obtained from applicant. By ticking the box and clicking the submit button, I hereby authorize Sterling Financial, its assigns, agents, banks or financial institutions to obtain an investigative or consumer report from a credit bureau or a credit agency and to investigate the references given on any other statement or data obtained from applicant.  Applicant’s Signature* (required)  × draw type  Date* (required)  Partner's Signature  × draw type  Date  Upload business bank statements for the last three (3) months. Upload or drag files here.  Submit Save