Equipment Financing Form

Apply by Phone 800-994-3415         Apply by Fax 800-994-4942

Apply Online https:\\

Tell Us About Your Company
q C- Corporation q Partnership q Corp q Sole Proprietor q Municipality
q 24 q 36 q 48 q 60 q skips/seasonal
q $1 Purchase Option q 10% Purchase Upon Termination q Fair Market Value Lease q Loan
Tell Us About Your Principal Owner
Equipment You Are Purchasing
Sales Representative

Applicant hereby represents that all information contained in this application is true, correct and complete. Applicant agrees that a digital record of this application shall be valid as the original. Applicant hereby authorizes us to execute and file any UCC fi nancing statements in its name upon approval of the application. The person submitting this application represents and warrants that he or she is authorized to prepare and submit this application on behalf of the Applicant and principals identified above.

Applicant acknowledges that submission of this application does not guaranty that Applicant will receive a finance proposal. Applicant further acknowledges that any proposals received by Applicant may be subject to satisfaction by Applicant of certain conditions or requirements of the lender issuing the proposal.

Security Code