|

|
Equipment Credit
Application |
|
100%
Financing Preserve Cash Tax Benefits |
|
APPLICANT-BUSINESS INFORMATION |
Company
Name:
|
Type: |
| Corp. |
Partn. |
Sole |
LLC |
| Phone # |
|
|
|
|
| Address |
City
State |
| Zip |
Fax # |
| Primary business function
|
# Years Current Owner
|
| Fed. Tax I/D |
| Equipment
Address if Different then Above |
City
State |
| Zip
Phone # |
|
| Ownership |
Name of Principal
#1
Title
Social Security#
% Ownership
|
| Home
Address City
State Zip
Phone #
|
Name of Principal
#2
Title
Social Security#
% Ownership
|
| Home
Address City
State Zip
Phone #
|
|
|
| Business
References |
| Bank Name (Business
checking/savings
account)
Account #
Contact
Phone
|
| Trade
Supplier/Creditor
Account #
Contact
Phone
|
| Trade
Supplier/Creditor
Account #
Contact
Phone
|
| Landlord/Mortgagor
Monthly Rent/Mortgage
Contact
Phone
|
|
|
EQUIPMENT &
CREDIT TERMS INFORMATION |
| Dealer
Name/Address
Contact
Phone
Fax
|
| Equipment description
(Attach itemized list if
available)
New
Used
Make/Model
#
$
|
|
|
Credit Terms:
24 mos. |
|
48 mos. |
|
Purchase Option: $1.00 |
|
10% |
|
FMV |
|
|