Business Contact Info
Credit Application for Business Account
Full Legal Company Name
*
Federal ID Number
*
No dashes please
Date Founded
*
-
Month
-
Day
Year
Date
Phone Number
*
-
Area Code
Phone Number
E-mail
*
Company Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
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Louisiana
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Rhode Island
South Carolina
South Dakota
Tennessee
Texas
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Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Company Type
*
Sole Proprietorship
LLC
Corporation
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Personal Guarantee Info
Owner & Guarantor
*
Full Legal First Name
Full Legal Last Name
Phone Number
*
-
Area Code
Phone Number
E-mail
*
Social Security Number
*
Date of Birth
*
-
Month
-
Day
Year
Date
Percentage of Ownership
*
Resident Status
*
U.S. Citizen
U.S. Resident
Work Visa
Pick one
Home Address
*
Street Address
Street Address Line 2
City
Please Select
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
State
Zip Code
Have you declared bankruptcy in the past 7 years?
Yes
No
Are you a homeowner?
Yes
No
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Agreement
(By checking these boxes you are agreeing to our terms - should you have any questions please contact us)
Agreement and Terms
*
By signing below or submitting electronically, the undersigning individual, who is either a principle credit applicant or a guarantor of its obligations, provides this written instruction to Victory Ave Equipment Financing Inc, its nominees or assigns, authorizing review of his/her personal credit and financial information on all business principles requested as part of said investigation. Such authorization shall extend to obtaining a credit profile in consideration of this application and subsequetnly for the purpose of update, renewal or the extension of such credit or additional credit and for reviewing and collecting the resulting account. A photostate or facsimile copy of this authorization shall be valid as the original. We affirm our identity as the respective individuals in the related application. All duplicates are to be viewed as valid as the original. Application requests in excess of $250k will require complete financial disclosure.
Signature
*
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