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To get a quote on your credit card transaction cash advancement eligibility please submit your information by completing the form below. An Allegiance Funding Solutions Consultant will contact you immediately with your requested quote.

Note: additonal information may be needed to provide you with the most accurate quote.

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Contact Name: Name of Business: Business Phone Number: Mobile Phone Number: Alternative Phone Number: E-mail: Fax: Does your business accept credit cards? No Yes Monthly credit card sales volume? Please Select One ----> $1,500 and Up $3,000 and Up $5,000 and Up $10,000 and Up $20,000 and Up $50,000 and Up $100,000 and Up $150,000 and Up $200,000 and Up $250,000 and Up How much money do you need? Please Select One ----> Between $1,500 and $3,000 Between $3,000 and $5,000 Between $5,000 and $10,000 Between $10,000 and $20,000 Between $20,000 and $50,000 Between $50,000 and $100,000 Between $100,000 and $150,000 Between $150,000 and $200,000 Between $200,000 and $250,000 $250,000 and/or More Months in business? Please Select One ----> Less Than 18 Months 18 Months or More Best time to call? Please Select One ----> Morning (8AM-11AM) Midday (11AM-2PM) Afternoon (2PM-5PM) Evening (5PM-8PM) Notes or Comments: