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Vendor Financing

Preferred Vendor Program


Ready to become a member of US Equipment Financing’s Preferred Vendor Program? Apply on-line now using the form below, or download a PDF of the form and fax to our offices at: 610-271-1073.

Company Information
 
Company Name:
DBA:
Company Address:
Suite/Room/Floor:
City:
State:
Zip:
Phone:
Fax:
e-Mail:
D&B Rating:
Tax ID:
# of Years In Business:
Company Type: Corporation
Partnership
Sole Proprietorship
LLC
LLP
Other
Leasing Coordinator Name:
Leasing Coordinator Phone:
 
Equipment / Product Lines to be Leased
Description of Equipment
 
Vendor Name:
Vendor Contact:
Vendor Address:
Suite/Room/Floor:
City:
State:
Zip:
Vendor Phone #:
Vendor Fax #:
Account #:
 
Business Ownership
 
Principal 1: Principal 2:
Title: Title:
SSN: SSN:
% of Ownership: % of Ownership:
Home Address: Home Address:
City: City:
State: State:
Phone: Phone:
e-Mail: e-Mail:
 
Bank Information
 
Bank Name:
Branch:
Phone:
Bank Officer:
Business Checking Acct#:
Loan Acct#:
 
 
 

 

 

Declaration

The undersigned individual certifies that the above information is true and correct. Applicant recognizeshat his or her individual credit history may be a factor in the evaluation of the credit of the applicant, hereby consents to and authorizes the above named business credit provider and any assignee, lender or funding service that may be utilized to obtain and use a consumer credit report on the undersigned, not and from time to time, as may be needed in the credit evaluation and review process and waives any right or claim they would otherwise have under the Fair Credit Reporting Act in the absence of this continuing consent.
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