My Account  |  0 item(s)    View Cart

Financing

Please provide the following information or CLICK HERE to print out our Credit Application (you must have Adobe Reader) and fax to us, 1-615-889-6773:


Lessee/Borrower Information

 

DBA (if any):
Company Name: *
Contact Name: *
Address: *
City: *
State: *
Zip Code: *
Phone:
Date Started:
Type of Business:



Tax ID #:
Nature of Business:
Equipment Location (if different):

 


Information on Principals

 

Name:
Title:
Social Security #:
% Ownership:
Complete Home Address:
(Include City, State and Zip)

Name:
Title:
Social Security #:
% Ownership:
Complete Home Address:
(Include City, State and Zip)

 

Bank References
*(Need previous bank if less than 3 years)

 

Name:
Phone Number:
Account No:
Contact:

Major Trade References

 

Name:
Phone Number:
Account No:
Contact:
Name:
Phone Number:
Account No:
Contact:
I/we hereby authorize Susquehanna Commercial Finance to investigate my/our credit worthiness and financial responsibility from the information provided above and from any other available sources. Please provide them with the information on the accounts listed above. You will be serving my/our best interests by responding promptly.

If you are entering into a lease transaction and the leased equipment is located in one or more of the states listed below, the leased equipment will be assessed and taxed for Personal Property Tax (PPT) by the appropriate taxing jurisdiction(s) of the location of the leased equipment.

AK - Alaska LA - Louisiana OR - Oregon
AL - Alabama MA - Massachusetts RI - Rhode Island
AR - Arkansas MD - Maryland SC - South Carolina
AZ - Arizona ME - Maine TN - Tennessee
CA - California MI - Michigan TX - Texas
CO - Colorado MO - Missouri UT - Utah
CT - Connecticut MS - Mississippi VA - Virginia
DC - District of Columbia MT - Montana VT - Vermont
FL - Florida NC - North Carolina WA - Washington
GA - Georgia NE - Nebraska WI - Wisconsin
ID - Idaho NM - New Mexico WV - West Virginia
IN - Indiana NV - Nevada WY - Wyoming
KS - Kansas OH - Ohio  
KY - Kentucky OK - Oklahoma  

 

Please type I AGREE or I DISAGREE in the following box to acknowledge your authorization.*
 
 
 
For more information about financing please visit our partner site, Susquehanna Bank, at https://www.susquehanna.net/scf/Forms/LeaseApplication/default.aspx?coName=InterstateMarketingCorp.