Loan Application

Company Information
Company Name
Org. Structure
Years in Business
Phone Number
Mobile Number
Contact Name
 
Address
County
City
State
Zip
Email
Business Description


Bank Information
Bank Name
Phone Number
Account Number


Principal Information (OFFICERS, PARTNERS OR GUARANTORS)

Full Name
Title
Social Security #
Ownership       %
Phone Number
 
Address
City
State
Zip
Full Name
Title
Social Security #
Ownership       %
Phone Number
 
Address
City
State
Zip


Vendor Information (EQUIPMENT SELLER)
Name
Address
City
State
Zip
Phone
 
Fax
Sales Contact
Equipment Type
Amount
Budgeted Monthly
Payment




Delivery of this application bearing a facsimile signature(s) shall have the same force and effect as if the application bore an inked original signature(s). The applicant certifies that all information provided is true, correct and complete and that the account will be used solely for business or commercial purposes. The applicant, owner(s) and guarantor (if any) authorize Union Capital Associates, Llc or its designee(s) or assignee(s) to obtain any information it may request from any business or consumer reporting agencies or other sources that provide credit reports, account history information, credit and employment history or similar information; such authorization shall extend to update renewal of credit and for reviewing or collecting the account. The applicant acknowledges that, based upon such information and other factors which may apply, Union Capital or its assignee(s) or designee(s), in their sole discretion, may either grant or decline to grant credit.