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Hidden Info
Current Position
Funding Request ID
Reason For Request
Status
Questionnaire Completed On
Account ID
Related Funding
Related Funding
Account
Related Funding
Owner
Related Funding Closer ID
Sales Partner
Stack
Compete
LA
PL
PF
LT
Request Type
Request Type
LA Reason
LA Reason 2
PL Reason
Second Reason
Options
Funding
PL Options
PL Funding
Use of Funds
PL Use of Funds
Additional Funding
Warning
LA/PL Funding
LA Funding
PF/LT Funding
Collection?
Yes
Status Pending?
Yes
Questionnaire Blank?
Yes
RType Blank?
Yes
Debit Date :
New Paying
New 3rd Party
New Funding Amount
New Debit Date
Paying Two
SF Reason
Request type:
Please select...
Account Statement - Account Ledger
Payoff Letter
Paid In Full Letter
Lien Release / Lien Termination Request
Reason for your request:
Please select...
Another lender is paying off my advance (3rd party payoff)
Inquiring about my account balance
Other Reason - Not Listed
Reason for your request:
Reason for your request:
Please select...
Pay off my advance
Accounting - Tax purposes
Account Balance Inquiry
Repayment Discrepancy
Other Reason
How will you be paying off your advance?
Third Party
I will be paying it off
*** Please note that if you are trying to pay off your advance, you need to request a Payoff Letter instead. Would you like to request a payoff letter?
Yes
No
Reason for your request
Reason for your request:
Would you like us to debit the balance directly from your bank account record?
Yes
No
Debit Date:
Reason for your request :
Please select...
Early Account Payoff
Other Reason
Reason for your request:
Reason for your request:
Reason for your request:
Reason for your request:
Please select...
Early Account Payoff
Other Reason
Name of Third Party:
How much is the Third Party funding ($):
Enter numeric only.
x
Would you consider obtaining additional funding from us?
Yes
No
Please input funding terms and details from our competitor:
Competitor's funding company name:
Funding Amount ($):
Payback Amount ($):
Payment Amount ($):
Repayment Frequency:
Daily
Weekly
Other
Select an option below
I would like to obtain additional working capital
I would like to review funding options from your company before obtaining competitor funding or paying off my account
None
Funding Amount Requested:
Use of proceeds:
Please select...
Inventory
Equipment
Pay Down Debt
Expansion / Renovation
Payroll
Working Capital
Receivables Delayed
General Cash Flow
Other
General Notes:
The Debit Date Must be at minimum 2 business Days from today.
How will you be paying off your advance?
Third Party
I will be paying it off
Reason for your request
Reason for your request
Would you like us to debit the balance directly from your bank account record?
Yes
No
Debit Date:
Reason for your request:
Please select...
Early Account Payoff
Other Reason
Name of Third Party:
Funding Amount Receiving ($):
Would you consider obtaining additional funding from us?
Yes
No
Please input funding terms and details from our competitor:
Competitor's funding company name:
Funding Amount ($):
Payback Amount ($):
Payment Amount ($):
Repayment Frequency:
Daily
Weekly
Other
Select an option below
I would like to obtain additional working capital
I would like to review funding options from your company before obtaining competitor funding or paying off my account
None
Funding Amount Requested:
Use of proceeds:
Please select...
Inventory
Equipment
Pay Down Debt
Expansion / Renovation
Payroll
Working Capital
Receivables Delayed
General Cash Flow
Other
General Notes:
The Debit Date Must be at minimum 2 business Days from today.
Your Request cannot be Completed
Please contact us for assistance via email:
funding@canacap.ca
Your Request has been Completed