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Application Form
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Comments
This field is for validation purposes and should be left unchanged.
Business Information
Amount To Buy Equipment
*
-- Choose an Option --
$100,000 - $200,000
$200,000 - $500,000
$500,000 - $750,000
$750,000 - $1,000,000
$1,000,000 +
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
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Years in Business
*
-- Choose an Option --
1 - 2 Years
3 - 4 Years
5 - 6 Years
7 - 8 Years
9 - 10 Years
10+ Years
NO START-UP Companies
Annual Revenue
*
-- Choose an Option --
$500,000 - $1,000,000
$1,000,000 - $3,000,000
$3,000,000 - $5,000,000
$5,000,000 - $10,000,000
$10,000,000 - $30,000,000
$30,000,000+
MINIMUM 12 Month Trailing Revenues $500,000
Business Structure
*
-- Choose an Option --
Corporation
LLC
Partnership
Sole Proprietorship
LLP
Non-Profit
Partnership
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
*
-- Choose an Option --
New
Used
Refurbished
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
Select files
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
Agreement
*
I agree
I certify that the above information is true and correct and I authorize any bank, financial institution, or trade reference to release any information as may be requested by National Equipment Finance and/or its assignees. I also hereby authorize National Equipment Finance and/or its assignees to obtain other background or credit information and understand that by signing below you are providing “written instructions” to National Equipment Finance under the Fair Credit Reporting Act, authorizing National Equipment Finance to obtain information from your personal credit profile or other information from Equifax. You authorize National Equipment Finance to obtain such information solely to conduct a pre-qualification for credit. TRUE AND CORRECT SIGNATURE/eSIGNATURE STATEMENT For the purpose of obtaining financing with any of the financial partners of National Equipment Finance and otherwise procuring credit from time to time, I have honestly and willfully furnished you with the information requested. I agree to and will notify you immediately in writing of any materially unfavorable change in any financial condition that may have an effect on our ability to finance, and in the absence of such notice, or of a new and full written statement, this may be considered as a continuing statement and substantially correct; and it is hereby expressly agreed that upon application for further credit, this statement shall have the same force and effect as if delivered as an original statement of financial condition at the time such further credit is requested. AS THE SUBMITTER OF THIS APPLICATION, I HEREBY CERTIFY THAT THE FOREGOING IS A TRUE AND CORRECT REPRESENTATION OF THE ABOVE-MENTIONED INDIVIDUAL, FIRM OR CORPORATION NOW ON FILE WITH NATIONAL EQUIPMENT FINANCE, AND THAT TO THE BEST OF MY KNOWELDGE AND BELIEF, THIS STATEMENT REFLECTS THE TRUE CONDITION OF THE BORROWER.
Signatures
Signature
*
Name/Title
*
Date
*
Month
Day
Year
Owner Information
Name
First
Last
SSN #
% Ownership (For 15% Owners )
Estimated FICO Score
-- Choose an Option --
Below 600
601-650
651-700
701 - 730
731 - 800
Unsure
Cell Phone #
Email Address
Enter Email
Confirm Email
Date of Birth
Month
Day
Year
Address
Street Address
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Own or Rent
-- Choose an Option --
Own
Rent
Other
Monthly Payment or Rent
How Long at This Address
-- Choose an Option --
0-2 years
2-4 years
4-8 years
8 years plus
Owner #2
Add Owner #2 Information
Owner 2 Information
Name
First
Last
Social Security Number
% Ownership (For 15% Owners )
Estimated FICO Score
-- Choose an Option --
Below 600
601 - 650
651 - 700
701 - 730
731 - 800
Unsure
Cell Phone #
Email Address
Date of Birth
MM slash DD slash YYYY
Title
Address
Street Address
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Patriot Act Compliance Information
Applicants Drivers License Number
*
Issuing State
*
-- Choose an Option --
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
Expiration Date
*
Month
Day
Year
Consent
*
I agree
I/We authorize National Equipment Finance or it's assignees to verify the information provided on this form as it pertains to application for credit. I /We also understand that my personal credit report may be pulled for verification purposes.
Signature of Applicant
*
Date
*
Month
Day
Year
Signature of Co-Applicant
Date
Month
Day
Year
Date
MM slash DD slash YYYY