Application Form - National Equipment Finance

"*" indicates required fields

Name

This field is for validation purposes and should be left unchanged.

Business Information

Amount To Buy Equipment*

Legal Business Name*

Copy of current business license required

Business Telephone*

Name of CPA / Phone Number*

Name or company name of financial advisor

Business Description*

A brief overview of your company services or products provided.

Name of Primary Bank*

Please attach a voided check with the document uploads

Business Address*

Street Address City State ZIP Code

Years in Business*

NO START-UP Companies

Annual Revenue*

MINIMUM 12 Month Trailing Revenues $500,000

Business Structure*

Company Website*

If You Don't have a Website don't bother filing out this form

Federal Tax ID #*

Trade Reference / Contact Information*

Trade Reference #2 / Contact Information*

Equipment Details

Please Provide Details on Each Piece of Equipment (Make, Model, Year, Etc.) *Attach invoices and images of equipment below*

If you have a long list of equipment please email to us proposal@nationalequipmentfinance.com * Private party transactions OK with special treatment

Purpose of This Equipment in the Business*

How will this equipment be used to grow the business, expand capacity or replace older or failing equipment?

Condition of Equipment*

All used equipment will require pictures of the equipment and a condition report or appraisal

Vendor / Seller of Your Equipment*

Complete name of Vendor including their website if they have one and a contact name and number.

Vendor / Seller Address*

Important information so we can pay any required deposits and communicate with the vendor on your behalf.

Where Will Equipment Be Located*

Required Attachments*

Drop files here or

Max. file size: 64 MB.

Scan and upload the following 1) Most recent financial statement 2) if there are no financials 3-months bank statements, 3) Copy of Drivers License Front/Back 4) Invoices for all equipment 5) Copy of current business license 6) Pictures of the equipment if used and 8) voided company check

Signatures

Signature*

Name/Title*

Date*

Owner Information

Name

First Last

SSN #

% Ownership (For 15% Owners )

Estimated FICO Score

Cell Phone #

Email Address

Enter Email Confirm Email

Date of Birth

Address

Street Address City State ZIP Code

Own or Rent

Monthly Payment or Rent

How Long at This Address

Owner #2

Add Owner #2 Information

Owner 2 Information

Name

First Last

Social Security Number

% Ownership (For 15% Owners )

Estimated FICO Score

Cell Phone #

Email Address

Date of Birth

Title

Address

Street Address City State ZIP Code

Patriot Act Compliance Information

Applicants Drivers License Number*

Issuing State*

Expiration Date*

Signature of Applicant*

Date*

Signature of Co-Applicant

Date