Brandywine Equipment Finance Corporation
Online Application
Company Name
Phone Number
Fax Number
E-mail
example@example.com
Company Billing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Federal ID Number
Company Type
Sole Proprietorship
Partnership
Corporation
Other
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Equipment Location (if different then billing)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Bank Name
Bank Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Bank Phone Number
Savings Account #
Checking Account #
Other Account #
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Guarantor Information
1st Principal's Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Cell Phone Number
SSN
E-mail
example@example.com
2nd Principal's Name
Address 2
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number 2
SSN
E-mail
example@example.com
3rd Principal's Name
Address 3
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number 3
SSN
E-mail
example@example.com
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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, the undersigned individual, who is either a principal of the credit applicant or a personal guarantor of its obligations, provides written instruction to Brandywine Equipment Finance Corporation or its designee (and any assignee or potential assignee thereof) authorizing review of his/her personal credit profile from a national credit bureau. Such authorization shall extend to obtaining a credit profile in considering this application and subsequently for the purposes of update, renewal or extension of such credit or additional credit and for reviewing or collecting the resulting account. Furthermore, this authorization provides authority to obtain other credit information, both corporate and personal, in regards to the following; banking and savings commercial/mortgage loan rating including opening date, high credit, term, payments, payment record and rating; equipment leasing or financing. A Photostat or facsimile copy of this authorization shall be valid as the original. By signature below, I/we affirm my/our identity as the respective individual/s identified in the above application.X
Digital Signature Name
*
First Name
Last Name
Digital Signature Date
-
Month
-
Day
Year
Date
Digital Signature Name 2
*
First Name
Last Name
Digital Signature Date
-
Month
-
Day
Year
Date
Digital Signature Name 3
*
First Name
Last Name
Digital Signature Date 3
-
Month
-
Day
Year
Date
Submit
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