Partnership Application ESU-Global Referral Partner Application Form must be filled out to by all Referral Applicants Name(Required) First Middle Last Date of Birth(Required) Month Day Year Are you a US Citizen or Legal Resident of the United States?(Required)-SELECT-US CitizenLegal Resident of the United StatesNoYou must be a citizen of the United States or Legal Resident Alien (Green Card Holder) to qualify as a a Referral Partner for E & S U Global LLCAre you an employee of a US based bank or lending institution?(Required)-SELECT-YesNoSocial Security Number(Required)Personal Email(Required) Personal Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone(Required)Your Company Name and Type (Ie., LLC, S Corp. Etc.,)(Required) Company Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country EIN Number (or TIN/FEIN)(Required)Website Please use the https:// format and NOT the www. formatBusiness Phone(Required)Business Email(Required) Business Start Date(Required) Month Day Year Prohibitions Regarding Marketing Activities(Required) I agree to the Prohibitions Regarding Marketing Activities detailed belowBroker/Partner agrees that it shall comply with the Telephone Consumer Protection Act (TCPA), CAN-SPAM, and any state or local statute or regulation relating to marketing or advertising which is similar. Broker/Partner is not authorized to, nor shall Broker/Partner, send or cause to be sent, any facsimile, text message or email solicitation containing E & S U Global LLC’s logo, and/or promoting the goods, products or services of E & S U Global LLC, or any facsimile, text message, or email solicitation that in any way refers to or could be construed to be on behalf of E & S U Global LLC. Broker/Partner shall not make any calls, whether pre-recorded or live, in which Broker/Partner promotes E & S U Global LLC’s goods, products or services unless such calls are in compliance in all regards with the Telephone Consumer Protection Act or any state or local statute or regulation regarding calls. Broker/Partner shall not send an email message to advertise or promote E & S U Global in any way unless such email complies in all regards with CAN-SPAM.Authorization(Required) I agree to the authorization policy detailed below.By checking “Yes”, you certify that all of the information provided by you on this application is true and complete. You authorize E & S U Global LLC., to verify all statements made by you with any source, obtain a credit check, background check, and employment history. You agree to provide any additional information that E & S U Global LLC., may deem necessary to process this application.Compensation Agreement(Required) I agree to the compensation policy.By checking I AGREE TO THE COMPENSATION POLICY, you understand that a separate NDA/COMPENSATION AGREEMENT will be provided and that the relationship between you (and or your firm) and E & S U Global LLC., will not commence until this document has been fully executed between you (and or your firm) and E & S U Global LLC., It is also understood that all compensation will be paid on the last business day of each calendar quarter that occurs no less than 30 days from distribution of funds to E & S U Global LLC., by the lending facility for the project submitted. Any distribution that occurs less than 30 days from the end of the calendar quarter will be distributed on the final business day of the following quarter. This policy is in place to protect E & S U Global LLC., in the event that a “claw-back” from the lender is activated as a result of the referred clients failure to service it’s debt in the manner detailed in the closing documents.W-9(Required) Drop files here or Select files Accepted file types: pdf, Max. file size: 100 MB. Please upload your W-9. For your convenience you may download the PDF from the dropdown in the “Join Our Team” section of the web-siteDriver's License(Required) Drop files here or Select files Accepted file types: jpg, gif, pdf, Max. file size: 100 MB. Please upload a color copy of your driver’s licenseVoided Check(Required)Accepted file types: jpg, gif, pdf, Max. file size: 100 MB.Please upload a copy of a voided check. Business account checks must match the details provided in the application regardless of D/B/A’s – Personal checking account information must match your personal details also provided in this application.
