Business Information Company Name: Sole Proprietor Partnership LLC
Corporation DBA (If Any): Mailing Address: Business Type: City: Years in Business:
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Tax ID: Bank Information
State of Incorporation:
Bank #1 Name Contact Name Date Opened
City Checking Acct Number Average Balance
Telephone
Guarantor Information (anyone with a 10% or more ownership in the company MUST be a guarantor) Guarantor #1 Name Telephone Cell SSN Title Ownership % Authorized to pull credit Yes No Address: Guarantor #2 Name Telephone Cell SSN City: Title
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Zip: Ownership %
Authorized to pull credit
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City: Equipment and Lease Information
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Equipment Description (incl Model Info): Vendor: Equipment Cost: Amount to be Financed: Telephone: Equipment Age (mos): Term Requested: Permission to Contact Given By Person completing this form: How did you hear about this site OR who referred you: Telephone: Email:
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