Company Information

Company Name

DBA

Fed Tax ID

No dash

Business Phone

Entity Type

Industry

Physical Address

Physical City

Physical State

Physical Zip/Postal Code

Is mailing address same as physical company address:

YesNo

Mailing Address

Mailing City

Mailing State

Mailing Zip/Postal Code

Mailing Address

Mailing City

Mailing State

Mailing Zip/Postal Code

State of Inc

Business Start Date

(ex. 01/01/1990)

What is your estimated annual revenue (total sales before any expenses)?

What was your net profit (after expenses) for last year (best guess)?

Tell us about your business finance request

Equipment to be Purchased

Equipment Description

Equipment Condition

Equipment Price

$

Palfinger Dealer

Page 2

Guarantor or Primary Contact Information

First Name

Middle Name

Last Name

Suffix

Email Address

Mobile Phone

Title

Preferred Method of Contact

Is company address same as home address?

YesNo

Home Address

Home City

Home State

Home Zip Code

Home Address

Home City

Home State

Home Zip Code

Social Security Number

Date of Birth

(ex. 01/01/1990)

Ownership %

%

Do you have additional guarantors?

Additional Guarantor Info

If you have more than 1 additional guarantor, please contact your representative.

First Name

Last Name

Email Address

Mobile Phone

Supplemental Information

How will this additional equipment be used?

How many employees do you have?

Current fleet size in operation for this company?

Total #of pieces of equipment currently in use for applying business

Are you a licensed contractor

How many crews do you run?

Financial Information

Do you have any tax liens?

Have you ever filed for bankruptcy?

When was the bankruptcy filed?

(Year only)

File Upload

To receive quickest turnaround time please attach the most recent 3 months of bank statements.

Bank Statements

Driver License

To help expedite documentation and funding

Acceptance

How did you hear about us?

Where did you see our ad?

Who referred you?

Which Trade Show?

Promo Code

By typing your name in the box below, the individual(s) who is either a principal of the credit applicant listed above and/or a guarantor of its obligations, provides authorization to AP Equipment Financing, its affiliates, and its designees (and any nominee, assignee or potential assignee thereof) to obtain and review his/her personal consumer credit report from a consumer credit reporting agency. This authorization shall extend to obtaining a consumer credit report, and additional consumer credit reports, now and again in the future for the purpose of (i) credit evaluation, assessing financial condition and review, including updating, renewing and/or the extending of such credit and/or (ii) reviewing and/or collecting the resulting account, now and from time to time. This authorization applies to this application, any future applications, any requests by you and/or applicant for credit and any solicitations by us to offer you and/or applicant credit. I/we waive any right or claim they would otherwise have under the Fair Credit Reporting Act in the absence of this continuing consent. In addition to authorizing the review of my / our consumer credit report from any consumer credit reporting agency, the undersigned also authorizes my/our financial institutions and creditors to release credit information required by AP Equipment Financing and its designees (and any assignee or potential assignee thereof). By typing your name in the box below, I/we affirm our identity as the respective individuals identified in the related application. The undersigned states that all of the statements and information in the application are true & complete.