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ZEROAPR application
Customer funding Info form
Some info we need to begin working on your file
Personal Info
Full Name
1
Email
Phone number
Mother's maiden name
Address Type
Own — Residential Address
Rent — Residential Address
Mailing Address (if different from residential)
Business Address (for business accounts)
Home Address
Tax ID type
Social Security Number (SSN)
Individual Taxpayer Identification Number (ITIN)
Employer Identification Number (EIN)
SSN
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DOB
Employment Status
Employed - Full-time
Employed - Part-time
Self-employed
Unemployed
Student
Retired
Homemaker
Freelancer/Contractor
Temporary/Seasonal Worker
Disabled
Total Gross Annual Income:
USD
CAD
EUR
Mortgage/Rent Payments:
USD
CAD
EUR
Drivers License
Upload a CLEAR picture of your Drivers License
Social Security Number
Upload a CLEAR picture of your Social Security Number
Bank Statement
Upload a CLEAR picture of your Bank Statement or Utility Bill with your NAME on it
Business Info
For business applicaitons
Business Legal Name
1
Business Structure
Select one...
LLC
Partnership
Sole proprietorship
EIN
Business Phone number
Business Established Date
Nature of Business
(Describe)
Annual Business Revenue
USD
CAD
EUR
Business Address
Is the business address different from the personal address?
Full Business Address
Login Username
Login Password
Answer to Security Question chosen
Experian 4-digit PIN
Credit Karma Login username
Credit Karma Login Password
I accept the
Terms
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