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Heavy Equipment Application

BUSINESS INFORMATION
* Required fields
*Company Name:
 *Business Phone:               *Business Fax:
   
*Physical Address:
 *Federal I.D. No.:             *Date of Incorporation:
           
*City:                               *State:  *Zip Code:
        		*Type of Business:
Corporation        Municipality         Partnership
Nonprofit            Proprietorship       LLC

*Years Under Same Ownership:
PERSONAL INFORMATION
 Include all owners to account for 100% of company ownership
Primary Contact: (First and Last Name)
 *Title:
*Home Address:
 *E-mail Address:
*City:                               *State:   *Zip Code:
       		*SSN:                     *Ownership %:
       
*Home Phone:                      *Business Phone:
        		Cell Phone:
*Credit Score:
Below 600     600- 660     660- 680     Above 680 		*If you have had a bankruptcy, please
  indicate year it was dismissed:  
   
EQUIPMENT INFORMATION
 
Equipment Description
Cab & Chassis:
*Make:
 *Model:
 *Year:
Notes:
 VIN:
 *Price:
Mounted Equipment:
Make:
 Model:
 Year:
Equipment Body:
 Serial #:
 Quantity:


*Location where equipment will be based (if different from above):
Business Address
Home Address
Other (please describe below) 		Address:

City:                                State:   Zip Code:
   
   
Equipment Seller
 
*Business Name:
 *Contact Name:  
*Address:
 *Phone:
*City:                             *State:  *Zip Code:
   


Comments
 

Please enter any other pertinent information about your company that that will help us in making a quick approval for your financial request.


The Applicants represent and warrant that all credit and financial information submitted to
UNIONWIDE FINANCIAL SERVICES is true and correct and that Unionwide Financial Services and it's assigns may obtain any credit information necessary pertaining to this application.
Submitting this questionnaire is equivalent to a signature.