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Business Info

Business Information Please fill in the spaces below and submit. By doing so, you are giving Phalanx, as well as its agents and affiliates, permission to review your business and personal credit history in order to provide you with formal funding approval.
Physical Address
Zip Code

Owner Info

Home Address

Funding Info

Important Questions


By signing below, each of the above listed business and business owner/officer (individually and collectively, “you”) authorize [Phalanx] (“GSCS”) and each of its representatives, successors, assigns and designees (“Recipients”) that may be involved with or acquire commercial loans having daily repayment features or purchases of future receivables including Merchant Cash Advance transactions, including without limitation the application therefor (collectively, “Transactions”) to obtain consumer or personal, business and investigative reports and other information about you, including credit card processor statements and bank statements, from one or more consumer reporting agencies, such as TransUnion, Experian and Equifax, and from other credit bureaus, banks, creditors and other third parties. You also authorize GSCS to transmit this application form, along with any of the foregoing information obtained in connection with this application, to any or all of the Recipients for the foregoing purposes. You also consent to the release, by any creditor or financial institution, of any information relating to any of you, to GSCS and to each of the Recipients, on its own behalf.
Credit Authorization

Credit Authorization I authorize the seller and its Assignee, Phalanx INC., and its subsidiaries or affiliates, to make whatever inquiries it deem necessary in connection with this credit application and in the course of its review or collection of any credit extended in reliance on this application. I further authorize any person or consumer reporting agency to complete and furnish to the seller and its assignee, Phalanx INC, and its subsidiaries or affiliates, any information that it may have to obtain in response to such inquiries, and agree that such information, along with the application, shall remain the Seller’s and its Assignee’s property, whether or not credit is extended. All information stated in this application is declared to be true representation of the facts and is made for the purpose of obtaining the credit requested. I acknowledge that my application for credit and any of the credit information you obtain will be submitted to Phalanx INC, and/or its affiliates or subsidiaries.

TCPA Disclosure

TCPA Disclosure By Clicking Submit Application, you agree to our privacy policy and authorize Phalanx INC. and its network of marketing associates and service providers to contact you at the phone number and/or email you entered using automated technology including auto-dialers, pre-recorded messages, and text messages, even if your phone is a mobile number or is currently listed on any state, federal, or corporate “Do Not Call” lists, and you are not required to give your consent as a condition of service. Providers include but not limited to: Affiliates Here (ALL). NOTE: THIS IS FOR DEMONSTRATION AND DEVELOPMENT PURPOSES ONLY, NO INFORMATION IS STORED OR COLLECTED AND ALL INFORMATION IS DELETED UPON SUBMISSION.