Business Credit Application

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Unparalleled Financial Services

Providing Businesses Funding Solutions

Business Credit Application

* Required Fields

Business Information

Business Name(Required)

DBA(Required)

Business Address(Required)

Street Address City State ZIP Code

Business Telephone(Required)

Business Fax

Business Email(Required)

How much money do you need?(Required)

Intended use of funds(Required)

Gross Revenue(Required)

Net Profit(Required)

Company Profile

Legal Structure(Required)

Corporation

S-Corporation

Limited Liability Company

Sole Propietorship

Employer Tax ID(Required)

Month/Year Started(Required)

Month/Year of Ownership(Required)

State of Incorporation(Required)

Nature of Business(Required)

Distributor

Wholesale

Manufacturer

Restaurant/Retail

Professional

Exporter/Importer

Other

Description of Business(Required)

What do you do, what do you sell?

Owner Information

Owner Name(Required)

Title(Required)

% Owned(Required)

Date of Birth(Required)

Social Security

Home Phone

Cell Phone(Required)

Home Address(Required)

Street Address City State ZIP Code

Own or Rent(Required)

Number of Years(Required)

Monthly Rent/Mortgage Payment(Required)

USA Citizen(Required)

Yes

No

Resident Status

Place of Birth

Driver License #

State

Issue Date

Authorization (Application required for each owner with 20% or more)

Each undersigned individual does hereby authorize the release of any and all credit information pertaining to the above credit application to Touchstone Finance & Leasing and/or its assignees. Such authorization shall extend to obtaining credit information including personal credit bureaus as well as bank and trade references.

Agreement(Required)

I agree to the the terms and conditions specified above.

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