Contact Us Ready to take your business to the next level? Contact us today for a free consultation. Have a question or feedback? Fill out the form below, and we'll get back to you. Pre Qualification Form Download , fill and upload pre-qualification form Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. File Upload File Upload Click or drag a file to this area to upload. Submit Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Apply Now Requested Amount *Business DBA *Date Established *Number of Employees *Type of Product/Service Sold *Total Monthly Sales (Average) *Business Structure *FranchiseOtherUse of Funds * Type of Entity *CorporationPartnershipSole ProprietorLTDLLCOtherEIN # / Tax ID Number (9 Digits) *Business Type *RetailWholesaleServiceLodgingManufacturingHealthcareOther Is This a Seasonal Business? *YesNo Total Monthly Card Sales (Average) *Business Name * State of Incorporation *AL|AlabamaAK|AlaskaAZ|ArizonaAR|ArkansasCA|CaliforniaCO|ColoradoCT|ConnecticutDE|DelawareFL|FloridaGA|GeorgiaHI|HawaiiID|IdahoIL|IllinoisIN|IndianaIA|IowaKS|KansasKY|KentuckyLA|LouisianaME|MaineMD|MarylandMA|MassachusettsMI|MichiganMN|MinnesotaMS|MississippiMO|MissouriMT|MontanaNE|NebraskaNV|NevadaNH|New HampshireNJ|New JerseyNM|New MexicoNY|New YorkNC|North CarolinaND|North DakotaOH|OhioOK|OklahomaOR|OregonPA|PennsylvaniaRI|Rhode IslandSC|South CarolinaSD|South DakotaTN|TennesseeTX|TexasUT|UtahVT|VermontVA|VirginiaWA|WashingtonWV|West VirginiaWI|WisconsinWY|WyomingDC|District of ColumbiaAS|American SamoaGU|GuamMP|Northern Mariana IslandsPR|Puerto RicoUM|United States Minor Outlying IslandsVI|Virgin Islands, U.S.Number of Locations *Time In Business (years) *Current Merchant Credit Card Processor Name * Average Bank Balance At End of Day *Business Address & Contact Address *Address Line 1City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip Code Business Phone * Business Email *Lease / Own *LeaseOwnMonthly Mortgage / Rent Payment *Other Credit Relationships Do you have any open MCA Accounts?YesNoMCA Remittance BalanceLoan Repayment TermIf Yes, MCA Funding Company Name Do you have any outstanding loans? Outstanding Loan BalanceMCA Estimated Term If Yes, Lender Name Loan Maturity DateOwner / Applicant Information Rent Type (Average) First Name *Last Name *Date of Birth *Job Title / Position *Home Phone (Optional)Ownership Percentage (1-100%) *Email Address *Cell Phone *Social Security Number (9 Digits) *Address *Address Line 1City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeCheckboxes *By checking here you agree that you have read and agree to Application Agreement, and Credit Profile Agreement (which authorizes ZCBCI to collect various types of information on your company, including background, consumer reports, credit checks, and credit card sales data)Checkboxes (copy) *By checking here you agree that you have read and agree to E-Sign Consent AgreementSubmit