EME - Credit Application

CREDIT APPLICATION
Applicant Contact Information
Contact Name

First NameLast Name
Applicant Phone Number
Format: (000) 000-0000.
Applicant Email
example@example.com
Applicant Role
Authorized Contract Signatory Information
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Business Information
Legal Business Name
Does Your Company Have a DBA Name"
If Yes, DBA Name
EIN Number
Business Address

Street Address Line 1

Street Address Line 2

CityState

Zip Code
Business Phone Number
Format: (000) 000-0000.
Business Tax ID
Please enter your Federal Tax ID or Employer Identification Number. If the business is a Sole Proprietorship, enter your Social Security Number.
Business Type
Business Start Date

MonthDayYear
2 digit month, 2 digit day, 4 digit year
Project Information

Please refer to the term sheet you received.
Project Customer Cost
Refer to your EME Term Sheet for the Total Project Customer Cost
Equipment Type
Refer to your EME Term Sheet for the Equipment Type
Equipment Description
Refer to your EME Term Sheet for the Equipment Description
Is the Project Location Different than the Business Address?
If Yes, please Enter the Project Location

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Billing Address
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Constellation Partner Information
Name

First NameLast Name
Email
I do not know my Constellation Partner's information
If the project size is over $250,000.00, financial documents will be required. Projects under 250,000, financial statements may be required if no commerical credit information available i.e.: D&B, Paydex, etc. Please submit with your application:

2 Years of Accountant-Prepared or Audited Financial Statements
(balance sheets, income statements and cash flow statements)
or
2 years of Tax returns

UPLOAD DOCUMENTS HERE
Please verify
Should be Empty:

CREDIT APPLICATION

Applicant Contact Information

Authorized Contract Signatory Information

Business Information

Project Information

Billing Address

Constellation Partner Information