Finance Quote Application

FINANCE QUOTE APPLICATION

Applicant Information

Entity Type

Select entity type (check all that apply) Individual    Sole Proprietorship    Partnership    Corporation    LLC    Other

Financing Request Details

Requested Amount: $   Desired Term:

Type of Financing Requested: Term Loan Equipment Lease Line of Credit Receivables Financing

Preferred Rate Structure: Fixed Variable   Desired or Maximum Interest Rate (if known):

Collateral and Security

Will you offer collateral as security for financing? Yes No

Financial Summary

Supporting Documentation

Please indicate which documents are attached or available upon request:

Financial statements (income statement, balance sheet)
Business tax returns (last 2 years)
Accounts receivable aging
Business plan / project proposals
Other (specify below)

Declarations and Authorizations

By signing below, the Applicant certifies that the information provided in this Finance Quote Application is true, complete, and accurate to the best of the Applicant's knowledge. Applicant authorizes the lender, its agents and service providers to verify any information provided and to obtain credit reports, business and personal, as required to evaluate the financing request. Applicant acknowledges that any quote provided by the lender is an indicative, non-binding offer and is subject to credit approval, documentation, collateral perfection, and compliance with applicable law.

Consent to Credit Inquiry: Applicant expressly consents to the obtaining of consumer and/or commercial credit reports as necessary for evaluation.

Non-Binding Nature of Quotation: Applicant acknowledges that any written or verbal quotation provided by the lender is valid only for the period stated in the quote and is non-binding until formal financing agreements have been executed by all parties. Fees, rates, and terms are subject to change prior to execution.

Terms & Conditions Summary

Fees: Applicant understands that application, origination, or due diligence fees may apply; any such fees will be disclosed in writing prior to execution of final documents. Applicant acknowledges responsibility for costs reasonably incurred in verification of provided information if financing is not completed due to Applicant's misrepresentation.

Governing Law: Any definitive financing agreement entered into will be governed by the laws of the jurisdiction specified by the lender; Applicants should review governing law and venue provisions in any such agreement.

Certifications

The undersigned certifies under penalty of perjury that the information provided in this application is true and correct. The undersigned further certifies that they are authorized to execute this application on behalf of the Applicant entity and to bind the Applicant to the declarations and authorizations set forth herein.

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