Fill Out, Print & Fax Application
1st Construction Equipment Financing
A Division of US Financial Group
Funding Preference
Select Preference:
Lease Equipment
Finance Equipment
Undecided
Company Information
Type of Company:
Proprietorship
Partnership
Corporation
Full Legal Name:
Address:
City:
State:
Zip Code:
Years in Business:
Phone:
Fax:
Mobile:
Email Address:
Mailing Address & Zip:
Description of
Your Business:
Comments:
Credit History
(Bankruptcies Within 3 Years Need Not Apply)
Previous Bankruptcies:
Yes
No
If Yes - Date Filed:
Date Discharged:
If Yes - Provide Details:
Previous Collections:
Yes
No
If Yes - Provide Details:
Previous Charge Offs:
Yes
No
If Yes - Provide Details:
Previous Judgments:
Yes
No
If Yes - Provide Details:
Explain All Previous
Credit Problems Not
Mentioned Above:
Principals of Company: Owner, Partners, President and etc.
Full Name & Title:
Home Address & Zip:
Home Phone:
Social Security No:
Full Name & Title:
Home Address & Zip:
Home Phone:
Social Security No:
Full Name & Title:
Home Address & Zip:
Home Phone:
Social Security No:
Equipment to be Funded
Please Provide a Full
Description of All
Equipment Needed:
Price Without Tax:
Terms (Months):
Purchase Option:
$1
10%
N/A
Other
If Other - Specify:
Equipment Dealer Information
Dealer's Name:
Address & Zip:
Phone:
Contact:
Banking & Checking Information
(Need 2 Accounts, or More - With 2 Year History)
Bank's Name:
Account Type:
Account No:
Phone:
Contact Person:
Bank's Name:
Account Type:
Account No:
Phone:
Contact Person:
Bank's Name:
Account Type:
Account No:
Phone:
Contact Person:
Trade References
(Provide 3 of Your Suppliers)
Name of Supplier:
Address & Zip:
Account No:
Phone:
Contact Person:
Name of Supplier:
Address & Zip:
Account No:
Phone:
Contact Person:
Name of Supplier:
Address & Zip:
Account No:
Phone:
Contact Person:
Statement of Understanding
I hereby represent and warrant that I am duly authorized by all necessary action to execute this application request on behalf of my company.
This application is given for the purpose of obtaining credit. I grant permission to US Financial Group to obtain a personal credit report (bureau) on all of the individuals that are listed above. I understand that individual credit histories may be a determining factor in the evaluation of this application.
I understand and agree that you may assign or transfer this credit application and that you may communicate the information contained herein to others to decide whether or not to extend credit.
I authorize the bank and business references listed above, as well as any of my/our lessors, landlords and any other past or present creditors to give any and all necessary information to you, or to your assignees or transferees, which will assist you in your credit inquiry.
I hereby certify under penalty of law that all of the foregoing information is true.
Please note:
This application will not be processed if it is not properly dated and signed below.
Date:
Sign Full Legal Name, Title:
