Equipment Finance Application

Equipment Finance Application

Equipment Finance Application

"*" indicates required fields

APPLICANT DETAILS:

Legal Name of Business or DBA*

Tax ID#

Address*

Street Address City State ZIP Code

Phone*

Date Est.*

Owner Name*

First Last

Birth Date*

SSN#*

Position

Ownership %

Address*

Street Address City State ZIP Code

Cell Phone*

Email*

Owner 2 Name

First Last

Birth Date

SSN#

Position

Ownership %

Address

Street Address City State ZIP Code

Cell Phone

TRANSACTION SUMMARY:

Finance Amount*

Transaction Type

Equipment Purchase

Working Capital

Other

Describe the use of funds and how this financing will result in add benefit to your business. For working capital requests, please be as detailed as possible.

Please list any available collateral (Please also provide further detail in a Facilities List, Personal Financial Statement, or Real Estate Schedule).

EQUIPMENT/VEHICLE VENDOR INFO:

Equipment/Vehicle to be financed

Price

Equipment/Vehicle to be financed

Price

Address

Street Address City State ZIP Code

Vendor/Seller

Phone

3 Months Bank Statements

Most Recent Bank Statements (all pages) from the last 3 Months

Drop files here or

Max. file size: 2 GB.

Invoice/Purchase Order

Invoice or Purchase Order of the unit you are interested in Purchasing

Drop files here or

Max. file size: 2 GB.

Owner Signature*

Date*

Owner 2 Signature

Date

Consent*

I accept the terms and conditions specified below and give authorization to verify my credit.

By my/our signature on this Application, either as a principal of the applicant or a personal guarantor of applicant’s obligations, I/we hereby declare under the penalty of perjury that all information contained in this Application and all financial information I/we provide is true, correct and complete as of the date it is being submitted to SCS or its designee. I/We understand that Creditor is relying upon this document and upon the information contained in it for the purpose of extending, modifying or renewing credit. I agree to inform Creditor immediately of any change or deterioration in the information or values stated herein. I/we authorize SCS, or its designee (and any assignee or potential assignee thereof), to verify any of the information from whatever source it deems appropriate, which authorization shall extend to obtaining and review of my/our personal credit profile from a national credit bureau in considering this Application and subsequently for the purpose of update, renewal or extension of such credit or additional credit and for reviewing or collecting the resulting account. If this Application for business credit is denied, you have the right to a written statement of the specific reasons for denial. To obtain the statement, contact SCS within 60 days from the date you are notified of our decision. We will send you a written statement of the reasons for the denial within 30 days of receiving your request for the statement. NOTICE: The Federal Equal Opportunity Act prohibits creditors from discriminating against applicants on the basis of race, color, religion, national origin, sex, marital status, or age (provided the applicant has the capacity to enter into a binding contract); or because all or a part of the applicant’s income derives from any public assistance program or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act. The federal agency that administers compliance with this law concerning this creditor is the Federal Trade Commission, Equal Credit Opportunity, Washington, D.C. 20580. A Copy or Facsimile of this Agreement with Signature shall be Considered to be an Original.

Equipment Finance Application