Freedom Ventures Landing

Personal Information

First Name *

Last Name *

Email *

Phone Number *

Referral Source *

Referral Contact

Date of Birth *

Address Line 1 *

City *

State *

ZIP Code *

SSN *

Dependents (if applicable) *

Funding Information

Requested Funding Amount *

Purpose of Funding *

Business Information

(if applicable)

Business Name

Business Type

Federal Tax ID (EIN)

Annual Revenue

Monthly Revenue

Industry Type

Do you own business real estate?

Yes

Real Estate Details

Financial Information

Do you own personal real estate? *

Yes

Personal Real Estate Details *

Other Assets (stocks, bonds, savings, etc.) *

Yes

Personal Other Assets Details *

Debts And Liabilities *

Yes

Debts And Liabilities Details *

Are all your taxes filed up to date? *

Yes

Do you currently owe taxes to the IRS or State? *

Yes

Does your accountant or CPA work with you on tax minimization strategies? *

Yes

Would you like to talk to our tax strategy team? *

Yes

Client Certification and Acknowledgement

I confirm that the information provided is true, accurate, and complete. I understand that Freedom Ventures Group (FVG) and its referral partners assume no liability for decisions made based on this application.

Signature *

Terms of Service (TOS) and Liability Disclaimer: 1. Accuracy of Information: By submitting this application, you affirm that the information provided is true, complete, and accurate. 2. Confidentiality and Data Use: Freedom Ventures Group (FVG) will maintain confidentiality and only share information as necessary. 3. No Guarantee of Funding: Submission does not guarantee funding approval or terms. 4. Authorization for Review: FVG is authorized to conduct necessary credit and financial reviews. 5. Client Responsibility: Consult professional advisors for legal, tax, or financial advice. 6. Indemnification: You agree to indemnify Freedom Ventures Group against claims arising from this application.

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Get the funding your business deserves with clarity and integrity

Get the funding your business deserves
with clarity and integrity