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New Client Intake Form
Contact Information
First Name
*
Last Name
*
Date of Birth
*
SSN / NIN
*
Email
*
Mobile Phone
*
Legal Company Name
*
Consent to Communications
*
Consent to Communications
By providing your contact information and signing below, you authorize Harbor & Muse and its representatives, successors, assigns, and designees to communicate with you via phone calls, text messages, and emails, including automated technology and pre-recorded messages, for informational, marketing, or transactional purposes. Standard message and data rates may apply. Message frequency may vary. You may opt-out at any time by replying "STOP" to text messages, unsubscribing from emails, or contacting us directly. You further authorize Harbor & Muse and its designees to obtain consumer, personal, business, and investigative reports about you from consumer reporting agencies (including TransUnion, Experian, Equifax, and Identity IQ), banks, creditors, government agencies, and other third parties (collectively, the "Recipients"). Harbor and Muse may transmit this application form, along with any information obtained in connection with it, to any or all Recipients for purposes related to commercial loans or purchases of future receivables (collectively, "Transactions"). You also consent to the release, by any creditor or financial institution, of any information relating to you, to Harbor & Muse and each of the Recipients. Harbor & Muse is authorized to communicate with the Recipients on your behalf and represent you in matters related to the Transactions.
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