Equipment Finance Application

Please fax to 800-341-6223

*Bold fields are required
Applicant Data: Business Information
Corp S Corp LLC Partnership Proprietor Yes No (Business or Personal)
Dealership Marina Other
Banking & Credit / Finance References
Company Principal / Guarantor Information
Yes No
Yes No
Description of Equipment to be Financed
       New Used
       Replacement Expansion
Lease Loan       
              Yes No       
Signature
Title
Date
Signature
Title
Date

Click the above checkbox to digitally sign the credit application
By checking this box, I certify that I am who I have represented myself to be in this application and that the information supplied is complete and true to the best of my knowledge. I authorize Priority One to obtain any information pertaining to my trade payoff from the lender. I certify that everything stated in this application and on any attachments is true and correct. Priority One and any participating lender may keep this application whether or not it is approved. By initialing below I authorize Priority One and any participating lender to check my credit and employment history and to obtain a consumer credit report in connection with this application or in connection with additional approval, extensions or collection of credit. I understand that I must update application information if my financial condition changes prior to closing of the loan. I am applying for individual credit and are relying on my own income or assets as the basis for repayment of the credit requested. Upon request I will be informed whether or not a consumer credit report was requested and if so the name and address of the agency that furnished such report. Evidence of physical damage insurance on the collateral securing the loan you seek is required prior to closing. By submitting this application you are authorizing us to disclose information contained in your application to an insurance carrier solely for the purpose of providing you with a premium quote for such insurance. You are however under no obligation whatsoever to purchase insurance from the insurance carrier providing the quote. Communication with Priority One Financial Services, Inc. or subsidiaries may be recorded or monitored for training purposes.