Equipment Financing Questionnaire
Business Contact Info
Company Details
Company Legal Name
*
DBA
if available
Company Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Contact Name
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Phone Extension #
Contact Email
example@example.com
Company Type
Sole Proprietorship
LLC
Corporation
Industry Type
Business Start Date
-
Month
-
Day
Year
Date
Last Year's Gross Income
This Year's Gross Income
Anticipated with equipment
Federal Tax ID (EIN)
OPTIONAL: For fastest approval upload 3 months of bank statements
Browse Files
Documents Securely uploaded
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of
Number of owners (20% or more shares)
*
Please Select
1
2
3
4
5
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Owner Information
20% or More
Name
First Name
Last Name
Middle name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Title
Percentage of Ownership
Date of Birth
-
Month
-
Day
Year
Date
Social Security Number
100% Encrypted
Signature Page
Owner
Agreement and Terms
INDIVIDUAL AUTHORIZATION: By signing below, the undersigned individual who is either a principal of the credit applicant or a personal guarantor of its obligations, provides EquipCash and its assigns written authorization to obtain and review his/her personal consumer report from any reporting agency in connection with this application, whether or not his or her credit is being relied upon in connection with this application. If you request, EquipCash will provide you with the name and address of the person to whom the request for any consumer report was made. You are entitled to receive certain information from that reporting agency upon request.
Signature
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Owner Information 2
20% or More
Name
First Name
Last Name
Middle name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Title
Percentage of Ownership
Date of Birth
-
Month
-
Day
Year
Date
Social Security Number *100% Encrypted
Signature Page
Owner
Agreement and Terms
INDIVIDUAL AUTHORIZATION: By signing below, the undersigned individual who is either a principal of the credit applicant or a personal guarantor of its obligations, provides EquipCash and its assigns written authorization to obtain and review his/her personal consumer report from any reporting agency in connection with this application, whether or not his or her credit is being relied upon in connection with this application. If you request, EquipCash will provide you with the name and address of the person to whom the request for any consumer report was made. You are entitled to receive certain information from that reporting agency upon request.
Signature
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Equipment Information
Desired Equipment or Currently in Use
Equipment
New
Used
Type of Equipment
Vendor Name
if available
Vendor Website
Equipment Cost
(approximate)
Additional Information
If Needed
Invoices or Brochure
Browse Files
If available
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