Phone: (770) 445-9019

Finance Application

Transaction Information

Term:

24
36
48
60
Other

Product Type:

Loan Lease Other

Total Equipment Cost

Net Trade

Cash Down

Taxes

Fees

Finance Amount

Equipment Information



Business Information

Business Address

Equipment Address

Billing Address

Type of Business

S-Corp
Nonprofit
Sole Proprietor
Partnership
Corporation
Government
LLC
LLP
Rental House

Tax Exempt

Yes No

Owner/Guarantor Information

Home Address



Home Address

The following authorization(s) shall apply to this application and subsequently for the purposes of update, renewal or extension of such credit and for reviewing or collecting the resulting account. A photostatic or facsimile copy of this authorization shall be valid as the original.

BUSINESS Credit Information: Authorization for Disclosure Applicant hereby authorizes the release of credit information to Wells Fargo Vendor Financial Services, LLC or its designee (and any affiliates, assignees or potential assignees thereof) from any source including credit bureau reporting agencies and applicant’s bank. I hereby represent that all of the information contained in this credit application is true, correct and complete. Applicant hereby authorizes Wells Fargo Vendor Financial Services, LLC to execute and file any UCC financing statements in its name upon approval of the application.

PERSONAL Credit Information: Authorization for Disclosure By signing below, the undersigned individual who is either a principal of the credit applicant or a personal guarantor of its obligations, provides written instruction Wells Fargo Vendor Financial Services, LLC or its designee (and any affiliates, assignees or potential assignees thereof) authorizing review of his/her personal credit profile from a national credit bureau.

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