Finance Application

Please fill out the form below as completely as possible. Thank You!

BUSINESS INFORMATION
Company Name:
* Contact Name:
Street Address 1:
Street Address 2:
City:
State:
Zip Code:
* Phone #:
Fax:
Email:
Type of Business:
Years in Business:
Nature of Business:
1ST PRINCIPLE INFORMATION
Owner Full Name:
Owner Percentage:
Home Address:
City:
State:
Zip Code:
Home Phone:
Cell Phone:
Email:
Best Time to Contact You:
Rate Your Credit:
2ND PRINCIPLE INFORMATION
Owner Full Name:
Owner Percentage:
Home Address:
City:
State:
Zip Code:
Home Phone:
Cell Phone:
Email:
Best Time to Contact You:
Rate Your Credit:
LOAN / LEASE INFORMATION
Purpose of Loan/Lease:
Description of Collateral:
Amount Requested:
Term Requested:
When do you need this funding?:
VENDOR / EQUIPMENT INFORMATION
Vendor Name:
Vendor Address:
City:
State:
Zip Code:
Phone:
Vendor Contact:
Equipment Description:
* Enter the Letters and Numbers from the Box to the Right for Security Purposes:
ACKNOWLEDGEMENT I (we) authorize and acknowledge that consumer credit reports and employment history reports about me will be requested by I-80 Equipment and third parties in connection with this application and/or on an ongoing basis in connection with updates, renewals, extensions or enforcement of any credit granted as a result of this application. I (we) certify that all of the information in this application is complete and accurate to the best of my (our) knowledge. Third party creditors will rely on this application in deciding whether to grant the credit request. I (we) authorize the sharing of information obtained in connection with this credit request, and any resulting loan, between I-80 Equipment and any third party creditor that evaluates the credit request. I (we) agree that this application shall be and remain the property of I-80 Equipment and any third party creditors that evaluate this credit request, whether or not this application is approved.