Credit Application
Credit Application
Branch Capital Group
Legal Company Name (If using DBA please include)
*
Company Name
Federal Tax ID #
*
Fed Tax ID#/EIN
Company Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Fax
Please enter a valid phone number.
Contact Person
*
First Name
Last Name
Title
Age of business
*
Nature of Business
Type of Business
*
Please Select
LLC
Sole Proprietor
Corp.
Partnership
Equipment Location (Complete only if equipment will not be at lessee's billing address)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Personal Information of Majority Stockholders / Owners
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
% Ownership
*
Social Security Number
*
Additional Stockholder / Owner
(If only one Owner, leave blank)
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
% Ownership
Social Security Number
Equipment to Be Leased/Financed
Equipment Description (Include quantity if multiple)
*
Equipment Condition Report
*
New
Used
Vendor Information
*
Vendor Name
Equipment Cost $
*
Vendor Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Vendor Phone
*
Please enter a valid phone number.
Lease / Loan Term
*
Please Select
12 Months
24 Months
36 Months
48 Months
60 Months
File Uploads / Equipment Invoice or Quote - (For financing amount over $50,000 include 3 months Bank Statements, prior Tax Returns, Photo Copy or picture of Drivers License)
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Signature - This application was completed for commercial purposes and is not intended for consumer purchases.I hereby authorize our banks, trade references, and financial institutions to release credit information to Branch Capital Group and/or its assignees.The undersigned individual, recognizing that his or her individual credit history may be a factor in the evaluation of the credit of the applicant, hereby consents to and authorizes Branch Capital Group and any assignee, lender, or funding partner to obtain and use a consumer credit report on the undersigned, now and in the future, as may be necessary during the credit evaluation and review process. I waive any right or claim otherwise available under the Fair Credit Reporting Act in the absence of this continuing consent.The Federal Equal Credit Opportunity Act (ECOA) prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national origin, sex, marital status, age (provided the applicant has the capacity to enter into a binding contract), receipt of income from public assistance, or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act. The federal agency that administers compliance with this law is the Federal Trade Commission, Equal Credit Opportunity, Washington, D.C. 20580.If your application for business credit is denied, you have the right to a written statement of the specific reasons for the denial. To obtain that statement, please contact Branch Capital Group at the address or email listed below.The applicant(s) further authorize Branch Capital Group to send future solicitations for lease or financing services via mail, text, fax, or email, including communications regarding collections or payment arrangements.
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