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Intake / form LX-04

Submit your specification.

Five steps: you, the business, its address, supporting documents, and your signature. A soft credit pull only, no fee at any point. Your progress is held on this device so you can step away and return — never your Social Security number, tax ID, date of birth, or documents. The file transmits once, directly to the review desk.

1 of 5 — About you Encrypted · soft pull only

Secure Application

  • Submitted over an encrypted connection.
  • Lextova is a funding marketplace, not a lender — financing is arranged through a network of third-party funding partners.
  • A soft credit pull only. No fee at any point in the application.

Privacy Policy

About you.

The person guaranteeing the file. Everything here stays between you, the review desk, and the partners who price it.

Enter your first name.

Enter your last name.

Enter your date of birth.

Enter the 9-digit SSN — used for the soft pull only.

That email doesn't parse — use [email protected] format.

The business.

The specification underwriting prices against — legal identity, scale, and the amount you need.

Enter the legal name of the business.

Enter the date the business started.

Select the state of incorporation.

Enter the business tax ID.

Enter the website, or check "no website".

Enter a 10-digit business phone.

Select the entity type.

Enter the amount you're requesting.

Enter a score between 300 and 850.

Enter your ownership percentage (1–100).

Enter the number of employees.

Select yes or no.

Select yes or no.

Select yes or no.

The address.

Where the business operates.

Enter the street address.

Enter the city.

Select the state.

Enter the 5-digit ZIP code.

Select yes or no.

The documents.

Bank statements move the file fastest — attach them now if you have them, or continue and the desk will request them later. PDF, PNG, or JPG, up to 4MB each.

Drop statements here, or browse Up to 3 files · PDF, PNG, JPG · 4MB each
    Drop additional documents here, or browse Up to 2 files · voided check, license, or anything relevant
      Review & sign.

      Read the file back, then sign to certify it.

      I certify the information is accurate and authorize its use to evaluate financing options.

      Full terms in our Privacy Policy.

      Check the box to authorize contact about this request.

      Sign above the line
      Mouse or touch

      Draw your signature to certify the application.

      Status: RECEIVED

      Application received. The desk reaches out after review.

      Your file is in the queue with everything attached. An advisor reads it, prices it across the partner network, and returns matched options — typically within 24 hours. Nothing proceeds without your sign-off.

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      Transmitted encrypted, once. Progress is kept on this device only so you can return to it — your Social Security number, tax ID, date of birth, and documents never are.