EmailMeForm
APPLICATION | NE
BUSINESS INFORMATION
Legal/Corporate Name:
DBA:
Physical Address:
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Telephone #:
###
-
###
-
####
Federal
Tax ID:
Date Business Started:
MM
/
DD
/
YYYY
Length of Ownership:
Website:
Email Address:
Type of Entity (circle one):
Please select
Sole Proprietorship
Partnership
Corporation
LLC
Other
Product/Service Sold:
Gross Annual Sales:
EBITDA:
How do you prefer to
communicate?
OWNER INFORMATION
Owner
Name:
First
Last
Title:
Ownership %:
Home Address:
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
SSN #:
Date of Birth:
MM
/
DD
/
YYYY
Cell #:
###
-
###
-
####
Approximate Credit Score
PARTNER INFORMATION
Partner Name:
First
Last
Title:
Ownership %:
Partner Home Address:
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
SSN #:
Date of Birth:
MM
/
DD
/
YYYY
Cell #:
###
-
###
-
####
Approximate Credit Score
LOAN REQUEST
Use of Funds
*
Please select
Working Capital
Equipment
Amount Requested
Requested Term Length
When are funds needed?
Equipment Cost
Purchase or Lease
Desired Term Length
Desired Monthly Payment
REQUIRED DOCUMENTS
Purchase Order/Invoice/
Sale Listing of Equipment
*
Add File
Most Recent Business
Tax Return
*
Add File
Most Recent Personal
Tax Return
*
Add File
Year to Date Financials
(P&L and Balance Sheet)
*
Add File
AR/AP Aging Report
*
Add File
Previous 6 months
bank statements
*
Add File
The below documents are not required at this time but may be requested, subject to the size of the loan request and credit profile:
Additional Year Business
Tax Return:
Add File
Additional Year Personal
Tax Return:
Add File
Previous Year Financials
(P&L and Balance Sheet)
Add File
Debt Schedule
Add File
EXISTING LOANS
Prior/ Current Loans (If applicable)
Company Name
Original Loan
Current Balance
1.
2.
3.
APPLICANT AUTHORIZATION
Applicant authorizes Northern Equipment Financing & Leasing, Inc., our assigns, agents, banks or financial institutions to obtain an investigative or consumer report from a credit bureau or a credit agency and to investigate the references given on any other statement or data obtained from applicant. Applicant provides authorization to receive communications regarding financing and this application for financing by telephone, email and/or text message and acknowledges the ability to opt-out of said communications at any time.
Signature
*
Clear
Your Name:
First
Last
Today's Date:
MM
/
DD
/
YYYY
Partner's Signature
Clear
Partner's Name:
First
Last
Today's Date:
MM
/
DD
/
YYYY
