Equipment Credit Application

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BBB Accredited Business

PLEASE NOTE: The equipment cannot be older than 2008 for it to qualify.
Where did you hear about us? (select one)   If Other:
 EQUIPMENT INFORMATION
Equipment Category (select one) *
Quantity:
Year: (No older than 2008) (Must be a 4 digit year)
Make:
Model:
Purchase Price: $ (Must be only a number...i.e. no commas or dollar signs, 80000, not $80,000)
Equipment Seller Company Name:
Street Address:
City, State: ,
Phone: ( ) - ext.
 PERSONAL INFORMATION   Include all owners to account for 100% of company ownership
Owner 1 Primary Contact
First/M.I./Last Name:
Title:
Ownership %:
SSN:
Home Phone: ( ) -
Business Phone: ( ) - ext.
Alternate Phone: ( ) - ext.
Email:
Home Address:
City, State Zip: ,

Owner 2
First/M.I./Last Name:
Title:
Ownership %:
SSN:
Home Phone: ( ) -
Business Phone: ( ) - ext.
Alternate Phone: ( ) - ext.
Email:
Home Address:
City, State Zip: ,

Owner 3
First/M.I./Last Name:
Title:
Ownership %:
SSN:
Home Phone: ( ) -
Business Phone: ( ) - ext.
Alternate Phone: ( ) - ext.
Email:
Home Address:
City, State Zip: ,
Has any Owner/Officer filed bankruptcy in the last 10 years?: Yes No

 BUSINESS INFORMATION
Company Name:
Business Phone : ( ) - ext.
Business Fax : ( ) -
Physical Address :
City, State Zip: ,
Years Under Same Ownership:
Type Of Business: Corporation Partnership Proprietorship Municipality Nonprofit LLC
Federal I.D. No.:
Date of Incorporation/Organization:
 Questions/Comments:

By submitting this application the applicant authorizes all parties contacted to release all credit and financial information requested by E Net Finance and/or assigns/designees to investigate all credit and financial information including but not ,limited to consumer credit reports, bank and trade references and account information for the purposes of processing this application for credit. 

* If alimony, child support or other maintenance income, it need not be disclosed if applicant(s) do(es) not intend to rely on such income.
All of the statements made by me (us) in this application are true and correct and have been made by me (us) in order to induce you to grant credit to me (us). I (we) have no outstanding obligations except as shown in this application and/or personal financial statement and no undisclosed law suits or judgements are pending or entered against me (us). I (we) understand that consumer reports may be requested from consumer reporting agencies in connection with this application. I (we) understand that upon request, I (we) will be informed whether or not a consumer report was requested and if a report was requested, informed of the name and address of the consumer reporting agency that furnished the report. I (we) authorize you to exchange credit information with others in connection with this application. I (we) agree that this application shall be and remain your property whether or not this application is approved.

IMPORTANT INFORMATION ABOUT OPENING YOUR NEW ACCOUNT TO HELP FIGHT THE FUNDING OF TERRORISM AND MONEY LAUNDERING ACTIVITIES, FEDERAL LAW REQUIRES ALL FINANCIAL INSTITUTIONS TO OBTAIN, VERIFY AND RECORD INFORMATION THAT IDENTIFIES EACH PERSON WHO OPENS AN ACCOUNT.