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Secure application

Bremen Capital

763 Marshall Way

Layton, UT, 84041

Main Application Link

Complete this secure financing application online

Sensitive identifiers are encrypted and shared only with your finance team.

Progress

Current: Business Information

Step 1

1. Business Information

Start with the company, contact, and basic business details.

Briefly describe what the company does.

Enter the incorporation date, if applicable.

Enter the number of years under the current ownership team.

Step 2

2. What You Are Looking For

Tell us what you want to buy, roughly what it costs, and how you would like the financing structured.

If you already have a vendor or seller in mind, include their name here.

Enter the primary contact person at the vendor.

Provide the full vendor address if available.

Use the best phone number for the vendor or supplier.

Tell us as much as you can about what you are looking to buy.

Where will the equipment primarily be located?

Enter the estimated total cost before any down payment or trade-in.

Step 3

3. Ownership & Personal Details

Add owner and guarantor details used for identity and underwriting review.

Step 4

Complete

4. Credit & Existing Debt

Share credit range, comparable debt, and any legal items that may affect financing.

Select yes if the business or any guarantor has a bankruptcy history.

Select yes if there are open or past suits, liens, or judgments to disclose.

An estimate is fine if you do not know the exact score.

Step 5

5. Bank & Trade References

Provide reference contacts in separate fields so the finance team can verify details quickly.

Step 6

6. Other Information

Please answer the following background questions. If you answer yes to any question, add a short explanation below.

1. Have you had an asset(s) repossessed by a creditor in the past 5 years?*

Not requested

2. Are you a co-signer or guarantor of any other debt?*

Not requested

3. Have you ever declared bankruptcy or had any judgments against you?*

Not requested

4. Are you currently under contract with any other mortgage brokers?*

Not requested

5. Are any tax obligations, including payroll or real estate taxes, past due?*

Not requested

6. Are you currently a defendant in any suit or legal action?*

Not requested

7. Are any assets held in trust?*

Not requested

8. Have you ever been convicted of a felony?*

Not requested

9. Are you party to any claims or lawsuits?*

Not requested

10. Are you a citizen of the United States?*

Not requested

Step 7

Complete

7. Review Application

Review all entered details before final authorization and submit.

Review everything below before submitting. If something is off, use the Edit button to jump back and fix it.

Business Information

Company

Not provided

Personal Guarantor?

Not provided

Primary Contact Name

Not provided

Cell / Alternate Phone

Not provided

Address

Not provided

Mailing Address / PO Box

Not provided

City

Not provided

State

Not provided

Zip

Not provided

Phone

Not provided

Email

Not provided

Business Website

Not provided

Federal Tax ID

Not provided

Nature of Business

Not provided

Date Business Incorporated

Not provided

Years Under Current Ownership

Not provided

Fleet Count

Not provided

Amount of Credit Desired

Not provided

Annual Revenue

Not provided

Approximate Net Worth

Not provided

Business Loan Type(s), Account #(s)

Not provided

What You Are Looking For

Amount of Credit Desired

Not provided

Do you have a down payment?

Not provided

If so, how much would you like to put down?

Not provided

Vendor or Seller

Not provided

Vendor Contact

Not provided

Vendor Address

Not provided

Vendor Phone

Not provided

Equipment Description

Not provided

Physical Location of Equipment

Not provided

Equipment Cost

Not provided

Equipment Condition

Not provided

Ownership & Personal Details

Do you rent or own your home?

Not provided

Owner 1 Name

Not provided

Owner 1 Title

Not provided

Owner 1 Date of Birth

Not provided

SSN

Not provided

Owner 1 SSN

Not provided

Owner 1 Home Address

Not provided

Owner 1 City

Not provided

Owner 1 State

Not provided

Owner 1 Zip

Not provided

Owner 1 Main Phone

Not provided

Owner 1 Mobile Phone

Not provided

Owner 1 Email

Not provided

What percentage of the company does owner 1 own?

Not provided

What percentage of the company does owner 2 own?

Not provided

Credit & Existing Debt

Bankruptcy History

Not provided

Suits, Liens or Judgments

Not provided

Estimated Credit Score

Not provided

Bank & Trade References

Bank Reference - Bank Name

Not provided

Bank Reference - Account #

Not provided

Bank Reference - Contact

Not provided

Bank Reference - Phone #

Not provided

Insurance Agent

Not provided

Insurance Agent Phone

Not provided

Trade Reference 1 - Company

Not provided

Trade Reference 1 - Contact

Not provided

Trade Reference 1 - Phone

Not provided

Trade Reference 1 - Account #

Not provided

Trade Reference 2 - Company

Not provided

Trade Reference 2 - Contact

Not provided

Trade Reference 2 - Phone

Not provided

Trade Reference 2 - Account #

Not provided

Trade Reference 3 - Company

Not provided

Trade Reference 3 - Contact

Not provided

Trade Reference 3 - Phone

Not provided

Trade Reference 3 - Account #

Not provided

Other Information

Have you had an asset(s) repossessed by a creditor in the past 5 years? (Borrower / Guarantor)

Not provided

Have you had an asset(s) repossessed by a creditor in the past 5 years? (Co-borrower / Co-guarantor)

Not requested

Are you a co-signer or guarantor of any other debt? (Borrower / Guarantor)

Not provided

Are you a co-signer or guarantor of any other debt? (Co-borrower / Co-guarantor)

Not requested

Have you ever declared bankruptcy or had any judgments against you? (Borrower / Guarantor)

Not provided

Have you ever declared bankruptcy or had any judgments against you? (Co-borrower / Co-guarantor)

Not requested

Are you currently under contract with any other mortgage brokers? (Borrower / Guarantor)

Not provided

Are you currently under contract with any other mortgage brokers? (Co-borrower / Co-guarantor)

Not requested

Are any tax obligations, including payroll or real estate taxes, past due? (Borrower / Guarantor)

Not provided

Are any tax obligations, including payroll or real estate taxes, past due? (Co-borrower / Co-guarantor)

Not requested

Are you currently a defendant in any suit or legal action? (Borrower / Guarantor)

Not provided

Are you currently a defendant in any suit or legal action? (Co-borrower / Co-guarantor)

Not requested

Are any assets held in trust? (Borrower / Guarantor)

Not provided

Are any assets held in trust? (Co-borrower / Co-guarantor)

Not requested

Have you ever been convicted of a felony? (Borrower / Guarantor)

Not provided

Have you ever been convicted of a felony? (Co-borrower / Co-guarantor)

Not requested

Are you party to any claims or lawsuits? (Borrower / Guarantor)

Not provided

Are you party to any claims or lawsuits? (Co-borrower / Co-guarantor)

Not requested

Are you a citizen of the United States? (Borrower / Guarantor)

Not provided

Are you a citizen of the United States? (Co-borrower / Co-guarantor)

Not requested

If you answered yes to any question, please provide an explanation.

Not provided

Step 8

8. Review & Authorization

Confirm the information is accurate and authorize the broker team to review the application.

By checking this box, I hereby authorize Bremen Capital, its affiliates, and any assigned lender or broker to obtain my credit report from one or more consumer reporting agencies, as well as any other information deemed necessary to process and evaluate my financing application. I understand this may include a hard inquiry that could affect my credit score. This authorization remains valid for 120 days from the date of submission.

By typing your name below, you agree that your electronic signature is the legal equivalent of your handwritten signature and that you intend to be legally bound by this agreement. You also confirm that you have read and understand the disclosures.

I consent to using electronic records and signatures, and I understand my electronic signature carries the same legal effect as a handwritten signature for this application.

Release authorization signature

By signing below, you authorize us to review the information provided for financing and underwriting purposes.

Ready to submit?

We’ll securely send the application to Bremen Capital for review.

Legal disclosures (19)

ECOA Anti-Discrimination Notice

The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national origin, sex, marital status, age (provided the applicant has the capacity to enter into a binding contract), because all or part of the applicant's income derives from any public assistance program, or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act.

USA PATRIOT Act Disclosure

To help the government fight the funding of terrorism and money laundering activities, federal law requires all financial institutions to obtain, verify, and record information that identifies each person or entity that applies for financing. When you apply, we will ask for your name, address, date of birth (for individuals), and other information that will allow us to identify you. We may also ask to see your driver's license, government-issued identification, business formation documents, or other identifying documents.

Adverse Action Rights Notice

If your application for business credit is denied, you have the right to a written statement of the specific reasons for the denial. To obtain the statement, please contact us within 60 days from the date you are notified of our decision. We will send you a written statement of reasons within 30 days of receiving your request.

SBA Broker Fee Restriction Notice

Bremen Capital is acting as a referral agent in connection with a U.S. Small Business Administration (SBA) loan program. Under SBA regulations, referral agents may not collect fees from the applicant until after the loan has been fully closed and funded. Any fee arrangement is subject to SBA guidelines and lender approval. Fees must be disclosed to and approved by the SBA lender prior to closing.

SBA Equal Opportunity Lender Statement

SBA programs are extended to the public on a nondiscriminatory basis. The lender processing this SBA loan application is an Equal Opportunity Lender. Complaints of discrimination may be filed with the SBA, Director, Office of Civil Rights, 409 3rd Street SW, Washington, DC 20416.

SBA Loan Guaranty Notice

This loan is being processed under the U.S. Small Business Administration's loan program, which provides a federal guaranty to the lender. The SBA guaranty does not reduce or eliminate the borrower's obligation to repay the full loan amount. Borrowers remain personally liable for the debt and any collateral pledged.

MCA — Not a Loan Disclosure

This transaction is a merchant cash advance, which constitutes a purchase of a specified amount of your future business receivables. This is NOT a loan. There is no fixed repayment term, no interest rate, and no scheduled payment amounts. The purchased amount will be remitted to the funder as a fixed percentage of your daily or weekly business receipts until the full purchased amount has been remitted.

MCA Factor Rate Disclosure

The cost of a merchant cash advance is expressed as a factor rate, not an annual percentage rate (APR). The factor rate for this advance is To be disclosed at the time of offer.. This means that for every $1.00 advanced, you agree to remit $To be disclosed at the time of offer. in future receivables. Because remittance amounts vary based on your actual sales volume, an APR equivalent cannot be precisely stated at the time of this agreement.

MCA Remittance / Daily Debit Disclosure

Remittances under this agreement will be collected via ACH debit on a To be disclosed at the time of offer. basis as a fixed percentage of your gross receipts. The specified remittance percentage is To be disclosed at the time of offer.%. Remittances will continue until the full purchased amount of To be disclosed at the time of offer. has been received by the funder.

Line of Credit Draw Terms Disclosure

This line of credit allows you to draw funds up to your approved credit limit of To be disclosed at the time of offer. during the availability period ending To be disclosed at the time of offer.. Each draw will be subject to applicable fees and interest from the date of the draw. Minimum draw amounts, draw fees, and repayment terms for each draw are described in your credit agreement.

Notice of Assignment

Upon execution of this factoring agreement, you assign to Bremen Capital LLC all right, title, and interest in the receivables described herein. Your customers will be notified that their invoices have been assigned to Bremen Capital LLC and that all payments must be made directly to Bremen Capital LLC. Payments made to you after notification of assignment must be immediately forwarded to Bremen Capital LLC.

Recourse vs. Non-Recourse Disclosure

This is a To be disclosed at the time of offer. factoring agreement. Under a recourse arrangement, if your customer fails to pay the assigned invoice within the agreed period, you are obligated to repurchase the receivable at full face value. Under a non-recourse arrangement, Bremen Capital LLC assumes the credit risk of non-payment due to your customer's insolvency or bankruptcy only. Disputes, offsets, and other non-credit reasons for non-payment remain your responsibility.

MCA Personal Guarantee Notice

This merchant cash advance agreement requires a personal guarantee from all owners holding a significant ownership interest in the business. By signing the personal guarantee, you agree to be personally liable for the full purchased amount in the event of default, misrepresentation, or breach of the agreement terms.

Equipment 'As Is' Condition Disclaimer

The equipment being financed is provided 'AS IS' and 'WITH ALL FAULTS.' The lender makes no representations or warranties, express or implied, including but not limited to warranties of merchantability or fitness for a particular purpose. The lender is not the manufacturer, dealer, or distributor of the equipment and assumes no liability for its condition, performance, or suitability.

Equipment Liability Waiver

The lender shall not be liable for any loss, damage, injury, or expense arising out of or in connection with the equipment, including equipment failure, malfunction, or defect. The borrower assumes all risk associated with the selection, possession, use, operation, and return of the equipment.

Equipment Insurance Requirement

Borrower is solely responsible for obtaining and maintaining property insurance on the financed equipment in an amount not less than its full replacement value, naming Bremen Capital LLC as loss payee. Evidence of insurance must be provided prior to funding and upon request during the financing term. Lapse in required insurance coverage constitutes an event of default.

Variable Rate Disclosure

The interest rate applicable to this line of credit is variable and is tied to a benchmark index rate. Your rate will be the index rate plus an applicable margin. As the index rate changes, your interest rate and payment amounts will change accordingly. There is no guarantee that the rate will remain at or near its current level for any period of time.

CRE Appraisal Requirement Notice

An independent appraisal of the subject property will be required as a condition of this financing. The appraisal must be conducted by a state-certified appraiser acceptable to the lender. The cost of the appraisal is the responsibility of the borrower and is non-refundable regardless of the outcome of the financing application.

Environmental Assessment Notice

The lender may require a Phase I Environmental Site Assessment and, if warranted, a Phase II ESA as a condition of this financing. The cost of any required environmental assessment is the responsibility of the borrower. The lender makes no representations regarding the environmental condition of the property.