EmailMeForm
EQUIPMENT FINANCING
ALL QUESTIONS MUST BE ANSWERED
Submissions that state “See Attached” or have missing information will be considered incomplete and applicant will be required to re-submit the form.
Company Name:
*
To be used to identify the loan application, moving forward.
Briefly describe what the Company does:
*
Price of Equipment:
*
Total Loan Amount Requested:
*
Down Payment Amount:
*
Business Information:
*
Legal Name of Business
Year Company Began
Company Address
Company Type (LLC, Corp, etc.)
Is Businesss in Good Standing/Active?
Has your company been involved in any Repossessions and/or Tax Liens?
*
Yes
No
If Yes, please explain:
Reason for Repossessions and/or Tax Liens (with date)
Additional Collateral - Equipment and/or Real Estate pledged to maximize funded amount (if any)
Estimated value of business owned Real Estate:
*
Estimated value of any other business assets:
*
2021 Revenue:
*
2021 Net Income:
*
Is the business currently making money?
*
Yes
No
If making money, for how many consecutive months?
if not making money, enter 0
What is your repayment strategy?
*
Additional Comments, if any:
Optional File Upload
ALL QUESTIONS MUST BE ANSWERED
Submissions that state “See Attached” or have missing information will be considered incomplete and applicant will be required to re-submit the form.
Equipment Invoices and Specifications
Last 3 Months of Complete Business Bank Statements
Personal Net Worth Statement (PNW)
Real Estate Owned Schedule (REO)
Mortgage Statements (if pledging mortgaged Real Estate as additional collateral)
Signature
Name:
*
Phone:
*
Email:
*
Confirm
Person completing the form is:
*
Broker
Principal Borrower(s)
Other
Referral Information (if applicable)
Name of person who referred you to us:
Email of person who referred you to us:
Account Executive (if applicable)
If you have been assigned an Account Executive (other than the person who referred you), please enter their email here.
Email of Account Executive:
