This Request for Funding Application ("Application") is a request by the above-listed business and business owners (individually and collectively, the "Applicant") to obtain funding from its representatives, agents, banks or financial institutions.

All information and documents that Applicant provides on or in connection with this Application ("Applicant Data"), is governed by the Whitehorse Financing Privacy Policy and subject to the terms of the Whitehorse Financing Customer Agreement.

Applicant certifies that (1) Applicant is authorized to submit this Application on behalf of the above-named business; (2) all Applicant Data submitted in connection with this Application are true, correct, and complete and may be relied upon by Whitehorse Financing, its affiliates and subsidiaries and any Lender that receives such Applicant Data; and (3) Applicant will notify Whitehorse Financing immediately of any material change to any Applicant Data, including its financial condition.

By checking the box below the Merchant and each of its owners/principals: (1) certify that all information and documents submitted in connection with this Application is true, correct, and complete; and (2) authorize Whitehorse Financing and its affiliates/representatives that may be involved with or acquire commercial loans having daily or weekly repayment features or purchases of future receipts, to obtain/receive credit reports and to obtain other relevant information from other third parties, to verify any information provided with this application.

Notice: If your Application is submitted to a Lender and subsequently is denied, you have the right to a written statement of the specific reasons for the denial within 30 days of Whitehorse Financing receiving your request for the statement. To obtain the statement, contact Whitehorse Financing within 60 days from the date you are notified of the credit decision. The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national origin, sex, marital status, age; because all or part of the applicant's income derives from any public assistance program; or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act.

By checking this box, Applicant (1) agrees that Applicant has read, understands, and agrees to the above certifications and the Whitehorse Financing Customer Agreement; (2) consents to the use of electronic signatures and that this checkbox and submission of the Application represents Applicant's electronic signature to this Application to have the same legal effect as a handwritten signature; and (3) acknowledges that Whitehorse Financing may terminate Applicant's Application if any of the foregoing certifications are or become untrue.

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