Apply | Nira Reserve

Capital Application

Please provide the information below for review.

Pre-qualification only. A soft credit pull may be used and will not affect your credit score.

Desired amount of funding? *

What is the main purpose of funds? *

Do you already have a business? *

Applicant Information

Information below is used for the pre-qualification review.

Name *

Last Name *

Date of Birth *

SSN *

Cell Phone Number *

Home Phone (optional)

Email *

Home Address *

City *

State *

Zip *

Employment & Income

Employer Name

Type of Employment

Occupation / Job Title

Annual Salary

Other Income / Year

Other Income Source

Verification

Which of the following can you use to verify your income?

Pay stubs

W-2

Tax Returns

I have income or other documents I want to upload now.

Income or other documents (optional)

Authorization

I have read and agree to the applicable Terms and Conditions and Privacy Policy. *

This is not an application for credit. A soft credit pull may be used solely for pre-qualification and will not affect your credit score. By submitting, you certify that the information provided is true and correct and authorize the company to obtain information from your personal credit profile or other information solely for pre-qualification purposes.

Applicant Signature *

Type your full legal name as your electronic signature.

Date *

Submitting this form does not guarantee approval, financing, terms, or availability. Any credit decision is subject to applicable lender requirements and final underwriting.

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