FINANCING APPLICATION The Silver Edge Finance Group
PLEASE COMPLETE and fax
to 559-834-5751
·
Required items in bold italics.
·
For transactions over $150,000,
two years' financial statements and
interims will be required.
·
If in business 3 years or fewer,
or if 20 employees or fewer, personal information may be required. When
transaction
exceeds $150,000, two years' tax returns and personal
financial statement also required.
Customer and Billing
Information
Company Legal
Name ________________________________________
Phone No. _______________________________
Fax No. _______________________________Email Address__________________________________________________
Tradestyle __________________________________
D&B # _____________________Federal Tax ID # _______________
Years in
Business _____ No. of employees
______
Type of Business: Sole Proprietor ____ Corporation _____
Partnership _____ Other (LLC, LLP, etc…) _____
Personal Information of
Proprietor, Pa
Principal Name _________________________________
Date of Birth_____________ Soc. Sec. No. _________________
Bank/Lease References
Name of Bank ____________________________________________
Checking Account
No. ________________________
Phone No. _____________________
Contact _________________________________ Loan Account No. ______________
Leasing Company
_______________________________ Phone No. ____________________ Account No.
______________
Authorization for
Disclosure of Credit Information (THIS MUST BE SIGNED)
The following
authorization(s) shall apply to this application and subsequently for the
purposes of update, renewal or extension of such credit and for
reviewing or collecting the resulting account. A photostatic
or facsimile copy of this authorization shall be valid as the original.
Authorization
for Disclosure of Business Credit Information
Applicant hereby
authorizes the release of credit information to Ditch Witch, or its designee
(and any assignee or potential assignee thereof) from any
source including credit
bureau reporting agencies and applicant's bank. I hereby represent that all of
the information contained in this credit application
is true, correct and
complete.
Signature
_______________________________________________________________________________________________
(Authorized
Representative of Credit Applicant)
Name
____________________________________________________________________________
Date _________________
(Please Print
Name)
The Federal Equal
Credit Opportunity Act 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), because all or part of the
applicant's income derives from any public assistance program, 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, DC 20580.
If your application
for business credit is denied or conditionally approved, you have the right to
a written statement of the reasons for the denial or the conditional approval.
Authorization
for Disclosure of Personal Credit Information
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
Ditch Witch, or its designee
(and any assignee or potential assignee thereof) authorizing
review of his/her personal
credit profile from a
national credit bureau.
Signature
______________________________________________________________________________________________
(An Individual)
Name
___________________________________________________________________________
Date _________________
(Please Print
Name)
Ditch Witch of
Arizona/Ditch Witch of Arkansas/Bay Area Trenchers/Ditch Witch of East
Texas/Ditch Witch of Houston
Ditch Witch of
Kansas/Ditch Witch of Oklahoma/Ditch Witch of the Rockies/Ditch Witch of
Sacramento/Witch Equipment