By submitting, you authorize Daniel Speiss LLC to review your request and contact you about capital options. Your information is reviewed for fit and only shared with funding partners as authorized or appropriate under the existing consent language.
The Merchant and Owner(s)/Officer(s) identified above (individually, and “Applicant”) each represents, acknowledges and agrees
that (1) all the information and documents provided to Daniel Speiss and Speiss C&C LLC (“Representative”) including credit card
processor statements are true, accurate and complete, (2) Applicant will immediately notify Representative of any change in such
information or financial condition, (3) Applicant authorizes Representative to disclose all information and documents that
Representative may obtain including credit reports to the other persons or entities (collectively, “Assignees”) that may be involved
with or acquire commercial funding having daily repayment features or purchases of future receivables, including Merchant Cash
Advance transactions, including without limitation the application therefor (collectively, “Transactions”), and each Assignee is
authorized to use such information and documents, and share such information and documents with other Assignees, in connection
with potential Transactions, (4) Representative and each Assignee will rely upon the accuracy and completeness of such information
and documents, (5) Representative, Assignees, and each of their representatives, successors, assigns and designees (collectively,
“Recipients”) are authorized to request and receive and investigative reports, credit reports, statements from creditors or financial
institutions, verification information, or any other information that a Recipient deems necessary, (6) Applicant waives and releases
and claims against Recipients and any other information-providers arising from any act or omission relating to the requesting,
receiving, or release of information, (7) each Owner/Officer represents that he or she is authorized to sign this form on behalf of
Merchant and (8) Applicant consents to receive marketing calls and texts from Representative and its affiliates or assigns using
automated technology. Consent is not a condition of funding. A copy of this authorization may be accepted as an original. Applicant
further agrees to the use of electronic signatures for the execution of this document, including, but not limited to, the use of
specialized electronic signature platforms.