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Business Information

Type

Mailing Address

Where Equipment will be Located

Same As Mailing Address
 

Has the Business or any Principal/Owner declared bankruptcy?

Is the Buisness or any Principal/Owner a party to lien or lawsuit?

Authorizing Officers

Officer

Home Address

 

Business Banking Information

Equipment to be Financed

Supplier Address

Equipment Information

Equipment Age

New     Used

Lease/Finance Term in Months

Residual

Electronic Signature

Terms

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 Atlas Small Business Finance (“Atlas SBF”) or its designee (and any assignee or potential assignee thereof) authorizing review of his/her personal credit profile from a national credit bureau. Such authorization shall extend to obtaining a credit profile in considering this application subsequently for the purposes of update, renewal or extension of such credit or additional credit and for reviewing or collecting the resulting account. A Photostat or facsimile copy of this authorization shall be valid as the original. Each of the undersigned affirms their identity as the respective individual(s) identified in the application received.
 
I agree to the above terms

Signature

 
 
* Indicates required field