Customer Financing

Commercial Credit Application

Equipment Details

Total Project Equipment Cost

Equipment Description

Company Information

Business Legal Name

DBA (if applicable)

Street Address

City

State

ZIP

Years in Business Under Current Ownership

Business Type
---Sole PropPartnershipLLCCorporationMunicipalNot for Profit

Federal Tax ID

Personal Information

Owner's Legal Name

Home Address

City

State

Zip

Email*

Home Phone

Social Security #

DOB

Additional Owner

Signature (Please Type Name)*

Date*

By signing above, the applicant and the Owners/Partners/Members/Guarantors agree as follows: They certify that all information provided is true, correct and complete and that the property leased or acquired with any credit provided will be used solely for business and commercial purposes. The applicant and the Owners/Partners/Members/Guarantors of the applicant listed above recognize that their individual credit histories may be a factor in the evaluation of the applicant for the credit it is applying for and, thus, authorize Ascentium Capital LLC or its designee to investigate their organizational and personal credit histories. This includes obtaining information from all sources including using their consumer credit reports in the credit evaluation and collection processes, and to update any such information periodically.

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