I. Contact info for person inputting the credit application data

II. Lessee/Borrower Info

Main Business Address

Country:

Corporate Info

Legal Structure that best describes the Organization seeking credit

US State of Organization

Bank Reference:

Bank Contact Name

III. Transaction info (Price, Equipment, Vendors, etc.)

Equipment Location

Other Address

Country:

Desired lease or financing structure

Add Equipment Vendor

IV. Ownership Information

Please share with us ownership information for

is owned by: (Select all that apply)

Will Owner Guarantee this transaction?

Is Owner a US Citizen

Does Owner/Guarantor own or rent their home?

Owner's Address

Country:

Will Owner Guarantee this transaction?

Is Owner a US Citizen

Does Owner/Guarantor own or rent their home?

Owner's Address

Country:

Remove

Will Owner Guarantee this transaction?

Is Owner a US Citizen

Does Owner/Guarantor own or rent their home?

Owner's Address

Country:

Remove

Will Owner Guarantee this transaction?

Is Owner a US Citizen

Does Owner/Guarantor own or rent their home?

Owner's Address

Country:

Remove

Will Owner Guarantee this transaction?

Is Owner a US Citizen

Does Owner/Guarantor own or rent their home?

Owner's Address

Country:

Remove

Will Owner Guarantee this transaction?

Is Owner a US Citizen

Does Owner/Guarantor own or rent their home?

Owner's Address

Country:

Remove

Will Owner Guarantee this transaction?

Is Owner a US Citizen

Does Owner/Guarantor own or rent their home?

Owner's Address

Country:

Remove

Will Owner Guarantee this transaction?

Is Owner a US Citizen

Does Owner/Guarantor own or rent their home?

Owner's Address

Country:

Remove

Will Owner Guarantee this transaction?

Is Owner a US Citizen

Does Owner/Guarantor own or rent their home?

Owner's Address

Country:

Remove

Will Owner Guarantee this transaction?

Is Owner a US Citizen

Does Owner/Guarantor own or rent their home?

Owner's Address

Country:

Remove
Add Additional Owner

Type of Entity

Type of Entity

Remove

Type of Entity

Remove

Type of Entity

Remove

Type of Entity

Remove

Type of Entity

Remove

Type of Entity

Remove

Type of Entity

Remove

Type of Entity

Remove

Type of Entity

Remove
Add Additional Ownership Entity
% Ownership Disclosed:
Please check.

By submitting application below, hereby confirms that s/he has read and agrees to the Credit Application Terms.

Credit Application Terms

By submitting this application, the individual(s) whose name(s) appear(s) within this application’s data field(s) above each individually as authorized representative(s) and/or principals and/or guarantors of the Applicant/Obligor, and on behalf of the Applicant/Obligor (individually and collectively “Applicant”), hereby affirms that the foregoing information contained in this Credit Application is presented for the purpose of obtaining or maintaining credit as of the date indicated and is true, complete and correct. Applicant understands Vision Financial Group, Inc. is relying on this statement of financial condition to extend or continue to extend credit to Applicant. Vision Financial Group, Inc., its affiliates, successors or assigns is/are authorized to make any investigation of Applicant’s credit either directly or through any agency employed by Vision Financial Group, Inc. for that purpose. Vision Financial Group, Inc. may disclose to any other interested parties our experience with this account. Applicant agrees to inform Vision Financial Group, Inc. immediately of any matter which will cause any significant change in Applicant’s financial condition. Applicant understands that Vision Financial Group, Inc. will retain this application whether or not credit is granted. Vision Financial Group, Inc. may share this application or information contained in or related to it with affiliates of Vision Financial Group, Inc. to determine Applicant’s eligibility for other products or services offered by Vision Financial Group, Inc.’s affiliates, unless you write to Vision Financial Group, Inc., at 615 Iron City Drive, Pittsburgh, PA 15205 to advise that you do not want this information shared.

ESTABLISHING A RELATIONSHIP WITH VISION FINANCIAL GROUP, INC: To help the United States Government fight terrorism and money laundering, it is our policy to request information that identifies each person or business that establishes a relationship with us. Therefore, for businesses we will ask for your business name, street address, and taxpayer identification number. For individuals we will ask for your name, street address, date of birth and social security number. We may also ask to see identifying documents. EQUALCREDIT OPPORTUNITY ACT: If your application for business credit is denied, you have the right to a written statement of the specific reasons for the denial. To obtain the statement, please contact our Customer Service Manager, 615 Iron City Drive, Pittsburgh, PA 515205 (888-834-3278) within 60 days from the date you are notified of our decision. We will send you a written statement of reasons for the denial within 30 days of receiving your request for the statement. NOTICE: The federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national origin, sex, marital status, age (provided the applicant has the capacity to enter into a binding contract); because all or part of the applicant’s income derives from any public assistance program; or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act. The federal agency that administers compliance with this law concerning this creditor is the Bureau of Consumer Financial Protection, 1700 G Street NW, Washington DC 20006.