IFI Credit Application Form

Industrial Finance, Inc. Credit Application

188 Lafayette Ave, Hawthorne, NJ 07506
PHONE (973) 304-2051 -- FAX (973) 304-2050
COMPANY NAME*
FEDERAL TAX ID NUMBER*
CUSTOMER NAME (Legal Name)*

PrefixFirst NameMiddle NameLast Name
MAILING ADDRESS*
PHYSICAL ADDRESS (PLEASE ENTER IF DIFFERENT FROM ABOVE)
MAILING ADDRESS*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
PHYSICAL ADDRESS (IF DIFFERENT FROM ABOVE)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
PHONE #*

Area CodePhone Number
FAX#

Area CodePhone Number
CELL#

Area CodePhone Number
EMAIL OF APPLICANT*
NATURE OF BUSINESS
NUMBER OF EMPLOYEES
YEARS IN BUSINESS*
INCORPORATION DATE

MonthDayYear
TYPE OF BUSINESS (OR APPLYING AS)

PROPRIETORSUB “S” CORPORATION“C” CORPORATIONLIMITED LIABILITY CO.PARTNERSHIP

EQUIPMENT AND TERM REQUESTED
EQUIPMENT DESCRIPTION
Equipment Cost
SELECT TERM REQUESTED
The undersigned certifies that the information requested above is accurate. The Company named above, its owners and/or principals, and all individuals whose names appear on the application expressly authorize consumer reporting agencies and other persons to furnish credit information to Lessor/Secured Party, separately or jointly with other creditors or lessors, for use in connection with this Agreement. Lessors / Secured Parties and joint users of such information are authorized to receive and exchange credit information and to update such information as appropriate during the term of this agreement.
The information provided in this application shall not be shared to anyone else and is kept confidential
I agree that the information herein are true and correct*

Yes
DATE OF SIGNATURE

MonthDayYear
Signature

Clear
Should be Empty:

Industrial Finance, Inc. Credit Application