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?
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 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 


COMPANY REVENUES

Last Year's Sales Sales YTD

MOST RECENT BALANCE SHEET

Total Assets
Total Liabilities
Net Worth

HOW MANY OTHER LENDERS HAVE SEEN THIS DEAL?
HOW DID YOU HEAR ABOUT US? ----------------------------------->

Comments or Summary (If Desired)
(You May Cut and Paste)

Thank you for submitting the online form. The person that handles your region will contact you shortly. By submitting this online form, you understand that you are providing this information for the sole purpose of assisting our Corporate Financial Group Division or assigns with its initial evaluation of your request and does not represent or imply a commitment or obligation to provide financing. All requests are subject to final approval. Again, thank you.

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