Corporate Finance New York

Equipment Application

TELL US ABOUT YOU

Please Select One
Brokers Please Click Here
Your Name
Company Name
Your Position/Title With Company
City & State
Website Address (if Any)
E-Mail Address
Telephone
Facsimile

TELL US ABOUT BORROWER

Company Name
City & State
Owner's Name
Type of Ownership
How Long In Business?
Date and State of Incorporation
Number of Company Owners
Is Your Company Public or Private?
If Public, Please Enter Symbol
Type of Business
Owner's E-Mail Address
Owner's Telephone
Owner's Facsimile
Company Website Address (If Any)
Do You Personally or Your Business Have Any Credit Problems? NoYes

If Yes, Please Explain
Has Your Company Been Profitable For The Last 3 Years? Yes No

If No, Please Explain
Any Lawsuits or Litigation Pending Against Borrower or Property? No Yes If Yes, Please Explain

ABOUT GUARANTOR

Guarantor's Name 
Date of Birth
Social Security Number
Home Address

COMPANY TRADE REFERENCES

Company Name  Telephone  Contact Name
Company Name Telephone Contact Name
Company Name Telephone Contact Name
Company Name Telephone Contact Name

COMPANY BANKING REFERENCES

Bank Name Branch
Bank Officer Telephone
Account Number  How Long
Outstanding Loans  Yes No If Yes, Describe
Bank Name Branch
Bank Officer Telephone
Account Number How Long
Outstanding Loans  Yes No If Yes, Describe

ABOUT YOUR REQUEST

Applying For:

Amount Requested
Use of Funds
Desired Terms

ABOUT THE EQUIPMENT

Type of Equipment
 Value Of Equipment

If Equipment Purchase - Please Provide:

Vendor Name  Equipment Description NewUsed
Telephone Equipment Location
Facsimile Total Sales Price
Address Down Payment
Salesperson Purchase Option (if applicable)
Price Per Unit Number of Units (Quantity)

If Refinancing Equipment Or Sale-Leaseback - Please Provide:

Description of Equipment and Number of Items   
General Condition of Equipment
Total Estimated Value
Average Value Per Unit
Date(s) of Purchase
Original Purchased Price
Original Down Payment

Describe Other or Additional Collateral Here 

YTD & LAST THREE 3 YEARS INCOME & EXPENSE OF THE BUSINESS

Sales Other Income Total 
Income		 Cost of
Sales		 Expenses Total Cost
of Sales & Expenses		 Net Operating Income
YTD

2009 
2008 
2007

MOST RECENT BALANCE SHEET (Not more than 60 days old)

Total Assets
Total Liabilities
Net Worth
HOW MANY OTHER LENDERS HAVE SEEN THIS DEAL?
HOW DID YOU HEAR ABOUT US? ----------------------------------->

Please Provide a Summary of Your Request
(You May Cut and Paste)
Thank you for your application. Because of the high volume of requests, we will only respond to requests that are accepted for further consideration. Please allow 3 business days for an email response. The term Applicant refers to "borrower", "client" and/or "customer".  The term "you" or "your" refers to the person submitting this information either as Applicant or on behalf of Applicant. By submitting this online form, you understand that you are submitting this information for the sole purpose to assist our corporate financial group division ("CFG") or its assigns with its initial screening process, and in no way implies a commitment or obligation on the part of CFG or its assigns to consider your request or provide any financing or service to you, Applicant, your company or affiliate.  No oral representation is ever made. You represent that the information provided on and with this form is true and correct, and that you are authorized to submit this form on behalf of the Applicant. Further, Applicant agrees to provide information, including financial information as may be reasonably requested by CFG and/or its assigns and grants permission to CFG and/or its assigns  to obtain information from sources related to Applicant's business and/or business and personal credit standings. Again, thank you, and we hope we can be of service to you and your business.

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