Merchant Cash Advance. Application Form

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1 Merchant Cash Advance Application Form

2 To: Whom it may concern PRIVATE & CONFIDENTIAL Dear Sir / Madam, OUR REF: DPL-BLS-001 DATE: 19 October 2012 RE: Merchant Cash Advance Service I write with reference introducing Digital Pays Limited, corporate advisory services and global payment processing service program. Our products and services range from consulting services, merchants account provisioning, merchant fraud prevention software and internet related services. We request all of our potential clients to complete, our application forms and engagement letter. Application Checklist Information Disclosure Form When returning the completed application form please include: - Your last 12 months merchant statements (all pages) Your last 3 months bank statements (all pages) 1 Void Business Account Cheque (main business account) Valid Photo ID (passport or drivers) for all partners/directors 2 pieces of letter headed paper Please post to: - Digital Pays Limited Unit 5, Warren Park Way, Warren Business Park, Leicester, LE19 4SA, England. Upon completion of the Banks or PSP Due Diligence Process a formal Offer Letter will be sent via Digital Pays Limited, but issued from the Bank or PSP confirming relevant Merchant Processing Costs Addition we can provide Merchant Processing Capacity for clients with extra websites and businesses. To proceed with the offer, complete the enclosed forms for the Banks or PSP letters to be issued. Yours Sincerely Digital Pays Merchant Account Provisioning Team

3 Merchant Business Cash Advance. The product is a multi-billion dollar industry in the US and has a hold in this country with the competition just scratching the surface at present. Based on the value of the monthly transactions passing through the prospects PDQ machine the Merchant Cash Advance is a simple short term unsecured advance. Repayment comes from utilising a percentage of the credit and debit card takings and is geared to be repaid within a 6 month term. However, unlike conventional loans there is no fixed sum monthly repayment for this cash advance, just a fixed percentage on each transaction. This gives the prospect some comfort in that if card takings fall for a couple of weeks so does the amount repaid whilst the percentage taken remains the same. The converse is true in that if they have a bumper week the advance is repaid quicker. There is also a mechanism for topping up the advance after 5 months so in effect it could become a revolving facility. We are not concerned what the funds are used for, within reason!! Stock, refurbishments, VAT payments, marketing/advertising, bridge insurance claim etc. etc. and it is suitable for any retail business that takes credit and debit card payments through a PDQ machine. Internet sales are however excluded from the product. Target market can include pubs, restaurants, hairdressers, florists, dentists, MOT/Repair garages, garden centres, opticians, vets, etc. Qualifying Criteria: - Been operating the business for a minimum of 12 months Have at least 12 months PDQ statements Be processing a minimum of 20 transactions a month Must not be heavily seasonal Averaging a minimum of 3,500 per month on card sales. Must be of good standing with the terminal provider reference taken If a tenant must have at least 12 months left on the lease and be up to date with the rent reference taken Maximum advance 25,000

4 Information Disclosure Authority Merchant Legal Name:.. I/we hereby grant our irrevocable permission to release our confidential information to Providers Business Cash and/or its affiliated companies (being its holding company or its subsidiary companies or any subsidiary companies of any such holding company). I/We understand that this information is being used for their credit/underwriting purposes only. This permission is specifically given to: - Merchant Account Provider: Merchant Account Name: Merchant Account Number (MID): Contact name: Phone number: Landlord/Mortgage Holder Company Name: Company Address: Contact Name: Phone Number: Reference/Mortgage account number: Signature... Signature... Print name Print name Date.. Date.

5 Merchant Information Form MERCHANT INFORMATION FORM Type of Entity: Limited Company Partnership Sole Trader Other Industry: Business Legal Name: Trading As: Trading Address Billing Address(if different) Telephone: Contact Name: Fax: Position: Company Registration: Website: Business Start Date: Applicant 1 Percentage Ownership: % Length of Ownership: Full Name: Home Telephone: Date of Birth: Mobile: Home Address: Prior Address if less than 2 years: Home Owner/Renter? Length of Residence: Driving Licence No: Applicant 2 Percentage Ownership: % Full Name: Home Telephone: Date of Birth: Mobile: Home Address: Prior Address if less than 2 years: Home Owner/Renter? Personal Bank Details: Length of Residence: Driving Licence No.:

6 Trade References BANKING & CREDIT CARD TERMINAL INFORMATION Company: Contact: Tel: Fax: Company: Contact: Tel: Fax: Company: Contact: Tel: Fax: Business Property Information Type of Building Free Standing Home Based Shopping Centre Office Other Own/Lease: Own Lease Monthly Rent /Mortgage: Lease Start Date: Landlord/Mortgage Co.: Term Remaining on Lease: Address Contact Telephone: Fax: Mortgage a/c No.: Last 3 months mortgage statement provided by merchant: Yes No

7 DATA PROTECTION ACT 1998 Sole Traders and Partnerships (including Limited Liability Partnerships) Completion of this application form By signing and submitting this form, the individual(s) named in this form are: applying for retail finance confirming to us that any details you have supplied are true and correct authorising us to make credit reference, fraud prevention and other enquiries in connection with this application as detailed below where we have explained the consequences of such enquiries and the use we will make of information we obtain about you and its disclosure you acknowledge your full understanding of these issues authorising us to disclose information to licensed credit reference agencies and fraud prevention agencies and others as set out below Considering your application We will use the information we gain from you or others in deciding whether to enter into any Agreement or continue with it. Information maybe requested from a credit reference agency search. Our search will be added to your record and will be seen by other organisations that make searches with that agency. We will also check your identity with our credit reference agency to prevent money laundering, unless you furnish us with other satisfactory proof of identity. Other uses and disclosure of information about you. Information about you will by used by us to decide whether and upon what terms to enter into an agreement with you; for training purposes, credit or financial assessment, market and product analysis and preparing statistics. We and other organisations may use and search your record at our credit reference agency to: It is important that you always give us accurate information. If at anytime you give false or inaccurate information or procure its passing to us, and we suspect fraud, we will record this. We may also give information about you and any proposed facility or facility granted and your performance there under to: any proposed guarantor or indemnifier of your obligations to us so they can decide whether to proceed; any banker or adviser acting on our or your behalf so they can carry out their services to us or you. Below are details of those credit reference agencies, fraud prevention agencies and other third parties referred to above from whom we obtain information about you. You have a legal right to these details. You also have a legal right to the receive a copy of the information we hold about you if you apply in writing. A fee will be payable. EQUIFAX CREDITSAFE GRAYDON EXCEL-A-RATE Business Services Ltd From time to time we may contact you by letter, phone, fax or to: keep you informed about services and products which we consider may be of interest to you; or to carry out market research about our products and services or those of third parties. If you do not wish to receive such information then please let us know by ticking the box below. We never pass your information to third external third parties for direct marketing purposes. Please do not send me any further information help make decisions about credit and credit related services, for you and members of your household; trace debtors, recover debt, prevent money laundering and fraud; manage your accounts or insurance policies; and prepare statistical analysis about credit.

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