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Vallexa Advisors
Leaders in Mergers & Acquisitions
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Welcome!
Behavioral Health for Sale
What is Behavioral Health?!
Healthcare Cash Advance
Frequently Asked Questions
Contact Us
application page
Behavioral Health for Sale
Contact Us
Frequently Asked Questions
Healthcare Cash Advance
Welcome!
What is Behavioral Health?!
application page
Application Form
Business Details
Business Description
Financial Information
Owner Information
Business Details
Legal Business Name
DBA Name
Business Street Address
City & State
Business Zip Code
Business Phone
Business Description
Owned Business Since
Business Open Date
Ownership
Own
Lease
Monthly Rent/Mortgage Payment
Lease Start Date
Business Description
Number of Employees
0-10
11-25
26-40
50-65
65+
Number of Locations
1
2
3
4
5+
Business Structure
Corp
LLC
Sole Prop
LLP
LP
Partnership
Other
Types of Electronic Payments Accepted
Average Month sales Volume From Electronic Payments
Estimated Monthly Total Sales
Requested Financing Amount
Are you Currently using a Billing Company?
Federal Tax ID Number
Is your Business for Sale?
Do you have any Federal or State Tax Liens?
Do you have any Outstanding Financing?
Have you filed for Bankruptcy?
Intended Use of Proceeds?
Owner Information
Principal Owner Name
Date of Birth
Principal Owner Home Address
Principal Owner Social Security Number
Principal Owner Email Address
Ownership Percentage
Principal Owner Home Phone
Principal Cell Phone
Past 4 Months Bank Statements
By Checking here the applicant Agrees & Electronically Authorizes to the following; The Business Applicant and each person signing this Application (“Signer”) certifies that all information provided by the Business Applicant and Signer is true and complete and authorizes VALLEXA, LLC and any of its affiliates (collectively “VALLEXA”) to: 1) obtain credit and/or employment information about the Business Applicant and Signer; 2) obtain credit reports and make any inquiries regarding the Business Applicant and VALLEXA considers appropriate in connection with this Application or reviews of the Business Applicant's account from time to time; and 3) disclose account information as permitted by law. The Business Applicant and Signer acknowledge that additional information may be required in order to render a decision on this Application.
By Checking here the applicant Agrees & Electronically Authorizes to the following; SIGNER ACKNOWLEDGES THAT VALLEXA MAY RELY ON THE STATEMENTS AND INFORMATION SET FORTH IN THIS APPLICATION AND THAT SUCH STATEMENTS AND INFORMATION MAY BE INCORPORATED BY REFERENCE IN ANY AGREEMENT ANY OF THE UNDERSIGNED MAY ENTER INTO WITH VALLEXA. EACH OF THE UNDERSIGNED HEREBY AGREES TO NOTIFY VALLEXA PROMPTLY OF ANY CHANGE IN ANY SUCH STATEMENT OR INFORMATION. SIGNER HAS READ AND UNDERSTANDS THE TERMS OF THIS APPLICATION, INCLUDING ANY ADDENDUM, AND REPRESENTS AND WARRANTS THAT THE INFORMATION CONTAINED HEREIN IS TRUE AND CORRECT.
By Checking here the applicant Agrees & Electronically Authorizes to the following; If applying for a loan, please note that the federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national origin, sex, marital status, age (provided the applicant has the capacity to enter into a binding contract); because all or part of the applicant's income derives from any public assistance program; or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act. The federal agency that administers compliance with this law concerning VALLEXA is the Federal Trade Commission, Equal Credit Opportunity, Washington, DC 20580.