(Company
Name)
(Contact
Name)
(Address)
(City)
(State)
(Zip)
(Area
Code and Phone No.)
(Area
Code and Fax No.)
(Area
Code and Mobile No.)
(Equipment
Location)
(County)
(Type
of Business)
(Years
in Business)
This company is a:
If corporation, please include:
(State
of Incorporation)
(Year
of Incorporation)
(Owner
1)
(SSN)
(Phone)
(Address)
(City)
(State)
(Zip)
(Owner
2)
(SSN)
(Phone)
(Address)
(City)
(State)
(Zip)
(Bank)
(Branch)
(Phone)
(Account
No.)
(Bank)
(Branch)
(Phone)
(Account
No.)
(Trade
Reference 1)
(Contact)
(Phone)
(Trade
Reference 2)
(Contact)
(Phone)
(Trade
Reference 3)
(Contact)
(Phone)
(Landlord/Mortgage)
(Phone)
(Vendor)
(Salesperson)
(Phone)
(Address)
(City)
(State)
(Zip)
(Type
of equipment)
(Cost)
Purchase Option:
Term of Lease:
BE SURE TO
PROVIDE COMPLETE & ACCURATE INFORMATION TO AVOID
DELAYS IN PROCESSING. PLEASE CONSIDER THIS DOCUMENT OR
A FAX THEREOF AUTHORIZATION TO FURNISH A COMPLETE
HISTORY OF ALL ACCOUNTS, LOANS, TRANSACTIONS, TRADE
INFORMATION, BALANCES OR OTHER FINANCIAL INFORMATION
RELATIVE TO ANY ACCOUNT WE MAY HAVE WITH YOU. I/WE
RELEASE INTERLINK FINANCIAL SERVICES OR ITS ASSIGNS FROM ANY
LIABILITY ARISING FROM ITS CREDIT INVESTIGATION.
(Applicant 1
Name)
(Date)
Applicant 1 Signature
(Applicant 2
Name)
(Date)
Applicant 2 Signature
Please
fill out the form completely, then follow the instructions