Section 2 | Revenue & Debt Figures

By signing and submitting this form, I/We confirm that the information provided above is true and accurate to the best of my/our knowledge. I/We authorize Value Capital Funding and/or any of its affiliates, partners, or representatives to contact me/us via phone, text, or email for the purposes of communication related to debt restructuring services. I/We understand that this is not a loan application and that no guarantees are made as to the outcome of any proposed negotiations or services. I/We further acknowledge that Value Capital Funding may perform a background check, credit review, or request additional documentation to support the evaluation process. I/We agree to provide all required documentation in a timely manner and understand that failure to do so may delay or prevent assistance. This authorization shall remain in effect until revoked in writing.