Vaultara Capital — Funding Intake

Before You Submit

Choose the funding type below. Then complete the form with as much detail as possible. We use this information to evaluate fit and respond by email with next steps.

Vaultara Capital is not a law firm and does not provide legal advice. For legal matters, consult a licensed attorney.

Funding Type

What type of funding are you seeking? (Required)

Business Funding Form

Full Name (Required)

Email (Required)

Phone (Required)

Best Time to Reach You (Optional)

Business Legal Name (Required) Business Address (Required)

Business Type / Industry (Required)

Time in Business (Required)

Funding Amount Requested (Required) Primary Use of Funds (Required)

Average Monthly Revenue (Required)

Estimated Annual Revenue (Required)

Owner/Guarantor Credit Range (Required) Any Open Collections / Late Payments? (Required) Additional Details (Required) I confirm the information is accurate and I agree to be contacted by email.

Personal Funding Form

Full Name (Required)

Email (Required)

Phone (Required)

State of Residence (Required)

Funding Amount Requested (Required) Purpose (Required)

Estimated Credit Range (Required)

Monthly Income Range (Required)

Employment Status (Required) Additional Details (Required) I confirm the information is accurate and I agree to be contacted by email.

Central Line: (800) 827-9016 • Email: contact@vaultaracapital.com

THANK YOU

We received your application. Our team will review it and contact you by email as soon as possible.