Broker Application

Fill out the form below to start your Broker partner application. One of our Broker relations managers will reach out to you shortly to finish your application.

Important Notice

We are not currently onboarding new Partners at this time, but a completed application below will put you in line when we resume at some point in 2022.
The partner experience is the product at Greenbox Capital, and we seek to maintain this service above all. We are currently working on an enhanced experience that will further differentiate Greenbox Capital. Once we go live, we will resume onboarding at that time. We look forward to working with you soon.

All fields marked by an asterisk (*) are mandatory.

Owner(s) Information

(Total ownership must equal to 100%)

First Name *

Last Name *

Cell Phone

Email *

Home Address *

City *

Province *

State *

Zip Code *

Date of Birth (DOB) *

Role Type *

Ownership Percentage *

Qualification Questions

How did you hear about Greenbox Capital? *

What brokerage *

Describe *

What are you looking for in a lender? *

Do you receive submissions from outside agents or 3rd parties? *

If yes, What percentage is from a 3rd party? *

Do you fund your own deals? *

What percentage of deals do you fund vs broker out? *

How does your company market to small business owners? *

Number of submissions we should expect each month? *

Number of monthly funded deals we should expect each month? *

Dollar amount funded we should expect each month? *

How many sales reps will sell our products? *

What other lenders do you currently work with? *

How many MCA positions do you fund your merchants? *

Do you charge a broker/application fee? *

How much? *

Do you have a contact that you want copied on all correspondence? If so, please provide a name, email address and telephone: *

Please enter the email you would like to use for confirmation of funding and commission information. *

By signing and faxing or emailing in this application to Merchant Capital Group LLC d/b/a Greenbox Capital (“Greenbox Capital”) you certify that all information provided in the Application and all other supporting documents provided to Greenbox Capital is true and complete in all respects and any dishonesty, incorrect and/or incomplete information will disqualify the Company from consideration for participation in Greenbox Capital’s ISO Partnership program. You understand and permit Greenbox Capital, and our agents and assignees, to contact third parties to make all relevant inquiries for the evaluation of your application, including, without limitation, completing a criminal background check, requesting business and personal credit bureau reports from credit reporting agencies and other sources, or for any update, renewal or other lawful purpose. Upon your request, we will advise you if we obtained a credit report and will give you the credit bureau's name, address, and report.

Please review your information. Once you submit your application, your entries can’t be updated.

Important Notice

Company Information

Owner(s) Information

Qualification Questions