Application for Financing

Application for Financing
By proceeding with and submitting this application, you expressly acknowledge and affirm that the finance requested is strictly for business purposes only. You understand and agree that this financial arrangement is not designed for personal, family, or household purposes. Furthermore, by moving forward, you are confirming your understanding of and compliance with all applicable laws and regulations governing business and commercial finance. You also represent and warrant that all information provided in connection with this application is accurate, complete, and truthful. You agree to indemnify and hold harmless the lender, its affiliates, and its agents from any and all claims, damages, losses, liabilities, costs, and expenses (including reasonable attorneys' fees) arising from any misrepresentation or breach of the affirmations and agreements made herein. Please review all terms and conditions carefully before accepting any financial product offered as a result of this application.
APPLICANT/CUSTOMER INFORMATION
Company Name*
Phone Number*
Address*

Billing Address

Street Address Line 2

CityState

Zip
Address*

Physical Address

Street Address Line 2

CityState

Zip
BUSINESS INFORMATION
Entity Type*
Year Established*
Facility Leased or Owned
SIC/NAICS
Est Rent Lease Payment
of Employees*
Est Value of your Fleet
EIN*
PO Required*

YesNo
Bankruptcy*

YesNo
Judgements*

YesNo
Tax Exempt*

YesNo
BANKING INFORMATION
Bank Name*
Account (Last 4 Digits)
Phone Number*
Address

Mailing Address

Street Address Line 2

CityState

Zip
MACHINE INFORMATION

(Optional Information Request)

Type a question

	Manufacturer	Model	Reason for Purchase(Upgrade, Replacement, Expansion, Other)
Unit 1
Unit 2
Unit 3

OWNERSHIP INFORMATION
Legal Owner Name - 1*
Date of Birth*

MonthDayYear
Date
SSN*
Address*

Mailing Address

Street Address Line 2

CityState

Zip
Ownership %*
Annual Income*
Net Worth*
Legal Owner Name - 2
Date of Birth

MonthDayYear
Date
SSN
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Type a question
Annual Income
Net Worth
Legal Owner Name - 3
Date of Birth

MonthDayYear
Date
SSN
Address

Mailing Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Ownership %
Annual Income
Net Worth
Terms and Conditions / Signature
The undersigned hereby requests Creative Equipment Solutions, LLC ("CES") to submit this application and any credit information to others for the purpose of providing financing for "Customer". CES partners with several entities to assist in the placment and establishment of these finance arrangements. Customer understands that CES is not the one providing the financing or establishing the credit. The undersigned affirms that he or she has full authority to sign on behalf of the company. CES at their sole discretion, may submit this credit application and other information to potential sources of financing/credit. Customer gives authority to the bank and trade references listed above to provide credit and financial information to CES and other potential financing/credit sources. Information includes, but not limited to: balances, payment history, spending patterns, establishment dates, and credit records. Customer and each person signing below on behalf of the Customer has verified the accuracy of the information above and gives full authority to CES and potential financing/credit sources to obtain business and personal credit reports. The Company and Undersigned fully agrees that the financing being requested is for BUSINESS PURPOSES ONLY. The Customer understands that the information contained in the "MACHINE INFORMATION" section is for information purposes only and is only used to provide information of what the customer intends to purchase to CES or the lender. The fact that the "Machine Information" section contains reference to specific machine information or pricing does not obligate CES or Lenderto any pricing commitments in any way. A facsimile or electronic signature shall have the same validity and effect as an original signature. The terms of this application are governed by the State of Arizona.
Signature*

Clear
Title*
Date*

MonthDayYear
Date
Signature

Clear
Title
Date

MonthDayYear
Date
Signature

Clear
Title
Date

MonthDayYear
Date
Should be Empty:

Application for Financing

APPLICANT/CUSTOMER INFORMATION

BUSINESS INFORMATION

BANKING INFORMATION

MACHINE INFORMATION

OWNERSHIP INFORMATION

Terms and Conditions / Signature