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Application form
CORE Fund Application
Step
1
of
14
7%
Dollar amount to be placed
(Required)
Distribution
(Required)
Choose your preferred distribution period.
3 year investment paying 22% every year
3 year investment paying 10% every 6 months
1 year investment paying 14% at the end of term
Name
(Required)
Use your
individual name
as shown on your personal income tax return.
If the funds are coming from an international account, please make it match the name on your account EXACTLY.
DO NOT USE A COMPANY NAME HERE!
First
Are you married?
(Required)
Choose Option
Yes
No
Spouse Name
Use your spouse's name as shown on your income tax return.
First
Beneficiary
(Required)
The combined allotted percentages for beneficiaries must add up to 100%.
Name of Beneficiary
Percentage allotted to Beneficiary
Add
Remove
Will the loan be taken out using your name or your business/entity name?
(Required)
Choose
My name
Business/entity name
Business/entity name
(Required)
How will you send your funds?
(Required)
Choose
Wire Transfer
Write a Check
Wiring instructions and the mailing address for the check will be sent via email immediately upon completion of the application. If you don't receive it, please check your spam/junk folder.
Your Date of Birth
(Required)
Must be over 18 years of age to participate in this program
MM slash DD slash YYYY
Spouse's Date of Birth
Must be over 18 years of age to participate in this program
MM slash DD slash YYYY
Email
(Required)
Contract, documents and renewal notices will be sent to this email.
Spouse's Email
Contract, documents and renewal notices will be sent to this email.
Cell Phone Number
(Required)
Address
(Required)
Use your address as shown on your income tax return
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Underwriting
Initial
(Required)
Enter your initial to signify that you have read and agree with the information above.
Underwriting
(Required)
I certify that the source of funds I am providing for this loan has not come in part or in whole from any illegal or illegitimate source(s).
(Required)
Consent 2
(Required)
I certify that the source of funds I am providing comes from expendable income.
(Required)
Consent 3
(Required)
I certify that I have spoken with my financial advisor to ensure this is a suitable option for me.
(Required)
Consent 4
(Required)
In the event that my loan is paid out later than the specified period specified in this contract, I understand that interest will be prorated accordingly.
(Required)
Federal Tax Classification
(Required)
Choose the appropriate option for your business.
Individual/sole proprietor or single-member LLC
Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership)
C Corporation
S Corporation
Partnership
Trust/Estate
Other (Such as Charitable LLC)
Choose the tax classification
Choose
C corporation
S corporation
Partnership
Enter other classification
Enter other classification
Social Security Number
(Required)
For tax purposes the government requires us to gather this information. This is a secure connection. Your information is not saved on our site and is never shared with anyone.
Employer Identification Number
(Required)
For tax purposes the government requires us to gather this information. This is a secure connection. Your information is not saved on our site and is never shared with anyone.
Signature
(Required)
Name
This field is for validation purposes and should be left unchanged.