Sapphire Application

Steps To Completing Your Sapphire Membership

Step 1: Choose your Membership

You have chosen the Obsidian Sapphire Membership. Please complete the online application below.

Step 2: Esign the Service Agreement

After you hit submit, you will be required to complete your signature on the electronic Obsidian Service Agreement.

Step 3: Verify your bank account

Once Application is completed and e-signed, you will be asked to verify your bank account. This is highly secure and 100% safe for you. Its a "Read Only" and the information will never allow anyone to change or update your account info. After account verification your activation fee of $350 and first months membership will be collected.

Step 4: Upload the required documents

After you have completed steps 1-3, then you will have access to a secure online upload section where you can upload all the requested files and documents needed to assist you with your membership. Once this has been completed and your membership activation has been collected, your Performance Advisor will contact you to begin going over your new M.A.P.P. (Massive Action Profit Plan).

Please Complete Your Sapphire Application Below.

Client Application

Choose Your Advisor Membership
Select Which Membership You Are Signing Up For*
Company Information
New business or existing?*
Legal Company Name*
DBA Name If applicable*
Franchise Brand
Business Description*
Physical Business Address*
Business Address 2 (suite or building #)
if none, put N/A
Business City*
Business State*
Business Zipcode*
State of Incorporation*
Entity Type*
Company Contact Name*
Company Contacts Phone*
Company Main Phone*
Company Fax*
Business Tax ID Number*
Duns Number*
Put NA if you don't know this.
Company Website*

Please enter http:// before your website address
Own or Lease your business location?*
Monthly Lease or Mortgage Amount*
Please enter a value between 0 and 100000000.
Name of Mortgage Company if own or name of landlord if lease*
Landlord/ Lenders phone number*
Number of Locations*
Please enter a value between 0 and 10000.
Business Income & Revenues
Date of Incorporation*
Business Industry*
Business Industry Type*
Length at current location?*
Years Under Current Managment*
Types of Goods Sold*
Last Years Annual Revenues?*
Please enter a value between 0 and 100000000.
Did you show a profit last year on your tax return?*
Average Monthly Revenue*
Please enter a value between 0 and 10000000.
Number of Monthly Deposits*
Average Daily Bank Balance*
Please enter your average DAILY bank balance and not your monthly. This is what your bank account averages on a day to day basis.
Do you accept Credit Cards?*
If yes, then who do you current process with?*
Delivery Method*
Delivery Time Frame*
States Doing Business In*
Sales Method*
Credit Card & ACH Information
This is needed for proper evaluation and requested by some lenders.
Total Monthly Credit Card Processing Volume?*
What is your Average Sales Ticket Size?*
What is your High Ticket Size?*
Type of equipment you use to accept credit cards*
Check the one that applies.
Multiple Types of Equipment you use*
Since you utilize multiple forms of payments, please select EACH one you use.
Have you ever had your credit card processing account shut down?*
If you got your processing shut down who was the processor?*
If you got your credit card processing shut down, explain why?*
Customer Refund Policy*
Number of days until products or services are delivered?*
Name of the Bank you use to deposit your CC batches*
Please list the bank name that you have your credit card batches deposited at.
Type of Building you are in*
Square Footage of Location Space*
Do you offer consumer financing to your customers?*
If yes to consumer financing then who is it that you currently use?*
Are you using a 2nd or 3rd look consumer finance lender?*
What is your current or estimated monthly financed Volume?
Ownership Information
Owner First Name*
Owner Last Name*
Position or Title with Business*
Percentage of Ownership (must be more than 51% or we need 2nd owner info)*
Owner Email*
Enter Email Confirm Email
Owners Mobile Phone*
Owners Date of Birth*
MM
DD
YYYY

Please put it in the following format 02/08/1964
Owners Social Security Number*
Owners Drivers License Number*
Drivers License Expiration Date*
Does Owner Rent or own home?*
Owner Address*
Owner City*
Owner State*
Owner Zipcode*
How long owner 1 been at this address?*
How is Owners Personal Credit?*
Are You Married?*
Ever been convicted of a Felony?*
Have you ever had a foreclosure?*
Have you filed for bankruptcy?*
If you have filed a BK, when was the discharge date?
Whats Owners Annual Salary?*
Please enter a value between 0 and 100000000.
2nd Owner Information
2nd owners percentage of ownership?
2nd owners first name
2nd owners last name
2nd owners title
2nd Owners Email
Enter Email Confirm Email
2nd Owners Phone
2nd Owners Date of Birth
MM
DD
YYYY

Please put it in the following format 02/08/1964
2nd Owners Social Security Number
2nd Owners Drivers License Number
Does 2nd owner rent or own home?
2nd Owners Home Address
2nd Owners City
2nd Owners State
2nd Owners Zipcode
How long owner 2 been at this address?
Owner 2 Are you married?
How is 2nd Owners Personal Credit Score?
Has 2nd owner ever had a foreclosure?
Has 2nd owner ever filed a Bankruptcy?
If yes to 2nd owner BK, when was the discharge date?

If unsure put N/A
2nd Owners Annual Salary
Please enter a value greater than or equal to 0.
2nd owner years with company?
Accounts Receivables Information
Current Receivables Total A/R Balance*
Current Accounts Payable Amount*
Current Amount of Inventory Value?*
Number of Open Receivables at Present?*
Estimated Number of Invoices Sent Per Month?*
Estimated Number of Customers*
Average Invoice Size*
Do you currently Factor your invoices?*
If yes, what company are you using?*
Factoring Company Contact Name*
Factoring Company Contact Phone*
Capital Funding Request
What type of financing are you seeking?*
Please select all of the types of financing you are looking to obtain.
How much capital are you looking for?*
What is the purpose for this capital?*
If you are completely unsure on how to answer this then simply leave it to the default Consolidating debts-working capital.
What is your maximum loan amount request?*
What is your minimum loan amount request?*
Does your business have any type of liens?*
If yes to Tax Lien, then are you in a repayment plan?*
Do you currently have any outstanding MCA loans?*
Original MCA Amount*
Whom are your MCA loan(s) with?*
Is MCA loan(s) more than 50% paid off?*
Equipment Request
Please complete all detailed information below if you are seeking equipment financing
Equipment Description*
Estimated Cost of Equipment*
we can include up to 20% soft cost for racking, wraps ect.
Budgeted Monthly Payment?*
Please enter a value between 0 and 100000.
Enter all of the vendors names here*
Banking Information
Name of your Bank*
Name on your business Bank Account*
This is the name listed on your bank statements.
Your Bank Contact Name*
Bank Contact Phone Number*
Put NA if you don't know this or enter the branch phone number.
Bank Contact Email if available*
Put NA if you don't know this.
Bank Account Type*
Business Bank Account Number*
Business Bank Routing Number*
Backup Credit-Debit Card Information and Deposit
Name on backup Credit-Debit Card*
This is to have on file as back up so that we can charge your account for services in case our ACH doesn't work. You will never be charged for anything without your consent.
Credit-Debit Card Number*
This is to have on file so as back up for our ACH agreement.
Credit-Debit Card Expiration Number*
Please enter same format as your card ex: 05/18
3 digit code on back of card (4 digits if Amex)*
Billing address for Credit-Debit Card*
Billing address 2 for credit-debit card*
Billing City for Credit-Debit Card*
Billing State for Credit-Debit Card*
Billing Zip Code for Credit-Debit Card*
Type of card to have on file as back up*
Trade References
Reference 1 Company Name*
Reference 1 Contact Name*
Reference 1 Phone Number*
Reference 1 Relationship*
Reference 2 Company Name*
Reference 2 Contact Name*
Reference 2 Contact Phone*
Reference 2 Relationship*
Reference 3 Company Name*
Reference 3 Contact Name*
Reference 3 Contact Phone*
Reference 3 Relationship*
Personal Financial Statement
Whats Owners Annual Salary?*
Please enter a value between 0 and 100000000.
Assets
Liabilities
Assets-Cash Savings & Checking In the Bank*
Liabilities-Accounts Payables Total*
Assets-Value of IRA, 401k or other retirement accounts*
Liabilities-Installment Account (auto)*
This can be an auto loan or any type of installment loan you have.
Asset-Accounts & Notes Receivable*
Liabilities-Loans On Life Insurance*
Assets-Life Insurance Cash Value*
Liabilities-Mortgage on Real Estate*
Assets-Total Stocks and Bonds amount*
Liabilities-Unpaid Taxes*
Asset-Automobile Present Value*
Liabilities-Other Liabilities*
Assets-Personal Property-Other Asset Amounts*
Liabilities-Total Liabilities*
Assets-Other Assets*
Total Assets*
Total Networth*
The total of your assets minus your liabilities.
Source of Income
Real Estate Income if any*
Net Investment Income*
Other Income*
Property A Type*
Property A Cost*
Property A Value*
Please enter a value between 0 and 1000000000.
Property A Mortgage Balance*
Please enter a value between 0 and 1000000000.
Property A Monthly Mortgage or Debt Payment*
Please enter a value between 0 and 1000000000.
Property A HELOC Amount*
Property B Type*
Property B Cost*
Property B Value*
Please enter a value between 0 and 100000000.
Property B Mortgage Balance*
Please enter a value between 0 and 100000000.
Property B Montly Mortgage or Debt Payment*
Please enter a value between 0 and 1000000000.
Property B HELOC Amount*
Property C Type*
Property C Cost*
Property C Value*
Please enter a value between 0 and 100000000.
Property C Mortgage Balance*
Property C Monthly Mortgage or Debt Payment*
Please enter a value between 0 and 100000000.
Property C HELOC Amount*
Obsidian terms and Conditions (This is required to submit)*
- By checking this box, I authorize Obsidian Business Advisors to obtain all my information and proceed to do their due diligence on me and my company. I also agree to allow Obsidian Business Advisors to charge my account on file for the $399 commitment fee which is due upon my signature of the client service agreement and may be credited back after hitting a few milestones with Obsidian.
- I Decline and understand that by refusing, I am not able to obtain services from Obsidian

Save and Continue Later

Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific

Steps To Completing Your Sapphire Membership

Step 1: Choose your Membership

Step 2: Esign the Service Agreement

Step 3: Verify your bank account

Step 4: Upload the required documents

Please Complete Your Sapphire Application Below.

Client Application

Choose Your Advisor Membership

Company Information

Business Income & Revenues

Credit Card & ACH Information

Ownership Information

2nd Owner Information

Accounts Receivables Information

Capital Funding Request

Equipment Request

Banking Information

Backup Credit-Debit Card Information and Deposit

Trade References

Personal Financial Statement

Assets

Liabilities

Source of Income