Funding Application

Thank you for considering us to assist in securing funding for your needs. To proceed, we need to collect some essential information through this form. The details you provide will enable us to identify the most suitable funding options and strategies for you.

Personal Information: Your basic details for identification and communication.

Identity Verification: Necessary to meet legal and regulatory requirements.

Employment Information: Helps us understand your financial background and stability.

Business Information: For entrepreneurs, this is crucial to assess the funding needs and opportunities specific to your business.

Your information will be kept confidential and used solely for the purpose of obtaining funding. Please fill out the form with accurate and complete information. If you have any questions or need assistance, don't hesitate to contact us. We are committed to supporting your financial goals and look forward to facilitating your funding journey.

Personal Information

Legal First Name *

Legal Middle Name *

Legal Last Name *

Email *

Please make sure this email matches with the email we have on file for you. Otherwise, your profile will not be updated in our system with the provided information.

Phone *

Date of Birth *

Address *

City *

State *

Postal code *

Country *

Time at Current Address *

Monthly Rent/Mortgage *

$

Have you worked with a funding company or consultant before? *

Yes

No

Identity Verification

Social Security Number *All sensitive information is encrypted and is not shared with any entity outside of Impruvu and approved partners.

Do you have a picture of your Driver's License you can upload? *

Yes

No

Driver's License *

ID Number *

ID State Issued *

ID Issued Date *

ID Expiration Date *

Employment Information

Are you employed by another company? *

Yes

No

Employer *

Employer Industry *

Employer Phone Number *

Occupation *

Employment Start Date *

Employer Address *

Employer City *

Employer State *

Employer Postal Code *

Employer Country *

Business Information

Do you have your own business? *

I own a business.

I want to start a business.

Business Name *

Business Industry *

Business Structure *

Business Start Date *

Business EIN *

EIN Obtained Date *

Business Phone Number *

Number of Employees *

Business Revenue *

$

Business Website

Business Address *

Business City *

Business State *

Business Postal Code *

Business Country *

Does it have credit or loans or any debts or derogatoriness like settlements? If so, briefly explain. *

Business Document Upload (Income Statements, EIN Confirmation, Business Formation, etc.)

I accept the RFI terms and conditions.

This Request for Information (RFI) does not create any representation, either express or implied, that:

• any tender or procurement process will proceed; or
• if a tender or procurement process does proceed, that the applicant’s tender or other form of application (if any) will be given any preference or special consideration.

Participants are still required to follow any tender or procurement process that may take place. This Request for Information does not indicate a commitment to any particular course of action.

Additionally, the applicant ensures that all information provided is accurate to the best of their knowledge and Impruvu LLC or approved partners are not held responsible for the financial decisions if inaccurate information has been provided.