This form is fill-able; please type in all of the required information, then print to sign, date, and initial.

Transcription

1 Instructions: This form is fill-able; please type in all of the required information, then print to sign, date, and initial. Fill out the Program Application (page 2-5) and the Billing Authorization Form (page 6) completely (signed, dated & initialed). Use the Document Checklist below to ensure you have everything in order. Fax, Scan/ the completed package to your consultant. Document Checklist: The main fax number is o Completed Program Application (pages 2-5) o Completed Billing Authorization Form (page 6) o Copy of Credit Card used for billing (front and back) o Copy of Driver s License (front and back) o Copy of your Articles of Incorporation or Certificate of Formation from your Secretary of State for your entity (if available) * Once you have verified that all the required documents are in order, please fax them, using this checklist as your FAX Cover Sheet, to Attention: Submissions. * To: Fax: Phone: From: Pages: Date: Copyright 2016 Premier Access Page 1 6

2 Personal Information: Please fill out Completely Full Name: (First, Middle, Last) Home Address: (Include City, State, Zip) Own/Rent: Home Phone: Address: Social Security #: Driver s License #: Issue Date: Mother s Maiden: Annual Household Income: Banking Relationships: Bank Name: Bank Name: Business Information: Business Name: Business Address: (Include City, State, Zip) Business Phone: Industry Type: EIN #: Annual Sales/or Projected Sales: Payment: Cell Phone: Date of Birth: State: Expiration Date: Pet s Name or Make of 1 st Car: Who do you bank with? Avg. Bal: Avg. Bal: Business Fax: Title/Position: Date of Formation: # of Employees: Years: Entity Type: *If you need a business entity established, please fill out the Entity Request Form on page 7, and we will contact you to go over the filing process and fees specific to your State after you submit your contract. * Credit Report Login Information: Username: Please enter the login information for us to access your credit report Password: Credit Monitoring Site: Copyright 2016 Premier Access Page 2 6

3 Credit Information: Have you filed for Bankruptcy in the last 10 years? Yes: No: If so, when did you file? Have you ever had a business account go to collection? If so, when? Do you currently have any Business Credit Cards? Yes: No: Certifications: Card 1: Card 2: Card 3: Card 4: Certifications: Please initial each statement as follows I the undersigned hereby certify the following: 1. I request that PremAcc Consulting, Inc. dba Premier Access Consulting apply for working capital lines of credit on my behalf. These may include Personal Credit Cards, Business Credit Cards, Lines of Credit, Revolving Credit Lines, Vendor Credit Accounts and Private Loans. 2. I have completed the application containing personal information and information on the business. I affirm that all of the information contained hereto is correct and true. I made no misrepresentations in the application, nor did I omit any pertinent information. I understand and agree that the potential lenders who receive the application(s) reserve the right to request supporting documentation. This may include verifying the information provided on the application with the applicant or other means. 3. I understand that I will be held responsible both personally and jointly with the business for any lines I choose to utilize or authorize any other person to utilize. Authorization to Release Information: As a part of the application and verification process, I authorize PremAcc Consulting, Inc. dba Premier Access Consulting to provide potential lenders via phone, fax, mail or internet any information in this document as part of the underwriting process. I also understand that my personal credit and/or business credit will be reviewed by potential lenders as a part of the underwriting process and that this will result in numerous inquiries in my personal and business credit report. Let it be known to all persons that I have given true, lawful and expressed permission for Premier Access Consulting to act on my behalf, in my place and in my stead, for the specific and limited purpose of applying for business credit accounts, processing and endorsing documentation with regards to those applications and the opening of an account for application correspondence to Premier Access Consulting for a period of 3 months from the Effective Date. I HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE ALL THE INFORMATION PROVIDED IS TRUE AND CORRECT. Authorized Signature: Date: Copyright 2016 Premier Access Page 3 6

4 Business Consulting Services Agreement Program Application This Business Consulting Services Agreement (this Agreement ), dated as of, 20 (the Effective Date ), is between and among (please print), an individual residing in the state of, for the purpose of carrying out the following matters set forth herein (Collectively Client, you, or your ), and PremAcc Consulting, Inc. dba Premier Access Consulting a Nevada Corporation ( Consultant ), as per the terms below. 1. SERVICES. Client retains and hires PremAcc Consulting to provide business consulting services to Client including, specifically, assistance incorporating or reorganizing a business entity, and establishing an EIN Number, or other similar account(s), and establishing multiple credit accounts on behalf of Client s business, including but not limited to Revolving Credit Lines, Lines of Credit, Bank Loans or other similar financial accounts (each an Account and collectively Accounts ) with lenders and other financial service providers (each a Lender and collectively Lenders ). At Consultants discretion and any time after the Effective Date, Consultant may evaluate the credit worthiness of Client by obtaining a credit report or other background information about Client or Client s Business from appropriate sources. Client hereby authorizes Consultant to obtain such information and agrees to take any further action necessary, as reasonably requested by Consultant, in order to assist Consultant with obtaining such information. 2. TERM. The term of this agreement shall be three (3) months from the Effective Date, only to be extended by mutual party agreement between Client and Consultant. 3. FEES. Client agrees to pay Premier Access Consulting the following fees (collectively the Fees ): a. Credit Establishment Fee: i. BILLING PROCEDURE: Client agrees to pay Consultant a total of Nine_ percent ( 9 %) of any and all lines acquired throughout the application process, and upon verification that each line has been approved for a specified amount. This fee will be determined based on total approval amounts awarded as a result of work performed by PremAcc Consulting and is not contingent on the Client s acceptance of or refusal of funds, or usage amounts. Client shall remit payment via the Credit Card sent with the Enrollment Packet, unless otherwise mutually agreed upon by PremAcc Consulting, that sufficient payment has been made by other means provided by the client. This includes check, money order, or any line of credit established through the program. ii. Upon commencement of applications, Client agrees to pay a minimum service fee of $2, or 9 % of total verified approved credit amounts (whichever is greater) in the event of cancellation. Cancellation requests must be submitted in writing by the Client and the Client understands that PremAcc Consulting cannot reverse, rescind, or cancel applications submitted prior to the cancellation request. iii. Client agrees to pay all other fees as stated on the Billing Authorization Form, including fees for Entity Filing, Credit Repair/Enhancement, License Research, or other fees as outlined in the agreement. 4. Interest Rates and Credit Terms: PremAcc Consulting makes no guarantees as to the set forth interest rate(s) and or terms which may be granted to Client. The promotional rates are determined by each bank and will typically range from 0% to 4.99% for 6-24 months. The interest rate set by the lender thereafter ranges from 9.99% to 22.99%, based on the credit worthiness of the client. Copyright 2016 Premier Access Page 4 6

5 5. Credit Line Reporting: PremAcc Consulting may apply for credit lines on behalf of Client to Banks that may choose to report the account to Personal Credit Bureaus (Equifax, TransUnion and Experian) and may be visible on Client s Personal Credit Report. A Bank may choose to report any business credit lines that are personally guaranteed to any of the Business and Personal Credit Bureaus for any reason. PremAcc Consulting in no way guarantees that the credit lines applied for on behalf of Client will not report to personal credit or the issuing Bank will not choose to report the line in the future. 6. Credit Limit(s): There is always the remote possibility that the issuing Bank or Lender may lower Client s credit limit, either arbitrarily or because of deterioration of Client s credit profile. Client hereby agrees and fully understands that such decisions are completely out of Consultant s control, and if such action takes place, PremAcc Consulting will not issue any refunds with no exceptions. 7. Credit Score/Inquiries: Client understands that applications made on Client s behalf by Consultant will result in inquiries appearing on Client s personal credit profile, which may result in a decline of Client s credit score. 8. CLIENT COVENANTS. At all times while in contract with Consultant, Client agrees to: a. Be truthful with Consultants and all Lenders/Banks and provide complete and accurate information, to the best of Client s knowledge, and will not mislead Consultants or said Lenders/Banks with respect to the Account(s), or Application Process. b. Cooperate with PremAcc Consulting and Employees of PremAcc Consulting in connection with the provision of the services, and any lack of cooperation from Client may result in termination of services. c. Keep Consultant apprised of all material developments with respect to Client s finances and business; d. Provide to Consultants all documentation, executed applications, notices, correspondence and or other information (collectively Account Information) within 30 days of the date received by or created by Client in connection with any Account; THIS CONTRACT IS BINDING. BY SIGNING AND DATING THIS CONTRACT YOU AGREE TO ADHERE TO THE LAWS OF NEVADA SHOULD A DISPUTE ARISE BETWEEN THE PARTIES. Authorized Signature: Date: Authorized Signature: Date: Copyright 2016 Premier Access Page 5 6

6 Credit Card Billing Authorization Form: * Make sure you include the following documents when submitting this application * Copy of your Billing Credit Card (front and back) Copy of your Driver s License, State ID, or Passport I, hereby authorize PremAcc Consulting, Inc. dba Premier Access Consulting to charge my credit card for the following charges adherent to the rules set forth in the Business Consulting Services Agreement. 9 % of Total Approved Lines - (This fee is charged upon verification of credit line approval) ** 3% Fee Applied to All Credit Card Transactions** Check All that Apply: $ Entity Establishment (This does not include fees paid to the Secretary of State) $ Credit Enhancement *We do not accept debit cards. Please provide a major credit card with sufficient available credit for authorization of fees* Card Type: Card Number: Expiration Date: CVV Code: Card Limit: Current Balance: Cardholder Name: Billing Address: City: State: Zip Code: Phone: Being the Cardholder or Authorized Signer, by signing below I understand and agree to the terms set forth in this agreement and the Business Consulting Services Agreement, agree to pay and specifically authorize PremAcc Consulting, Inc. dba Premier Access Consulting to charge my card when appropriate. Authorized Signature: Date: Copyright 2016 Premier Access Page 6 6

7 PROGRAM APPLICATION Entity Formation Request Form: Top Three Name Choices: *your name should not be the name of the franchise you re buying into, you will have to file a DBA/Fictitious Business Statement to adopt the franchises name* Entity Type: (Check One) Industry Type: Business Address: Business Phone Number: Projected Annual Sales: Corporation: LLC: Sole Proprietor: City/State/Zip How Many Members/Officers? Member/Officer 1: Member/Officer 2: Address: Member/Officer 3: Address: Address: Member/Officer 4: Address: Permission to Establish Entity: I/We hereby give PremAcc Consulting, Inc. dba Premier Access Consulting expressed permission to establish an entity using the information contained herein on my/our behalf with the appropriate government entity in my/our State of Residence, which is. I/We understand that Premier Access Consulting and its Representatives are not Certified Public Accountants and cannot give tax advice, and are merely establishing and entity on my/our behalf for the general purpose of doing business in my/our home state. Any business licenses, tax permits, sales permits or other licensing shall be acquired personally. I/We also give permission to establish an EIN number through the IRS for my/our newly established business. I/We give permission to use the credit card given on the enrollment application for any fees required associated with establishing the aforementioned entity. Copyright 2014 Premier Access 7 P age