Attn: Jim Paullus, 256 Garner Dr, Mabank, Texas 75156

Phone   903-451-9590

Fax       903-451-9560                           

256 Garner Dr.

Mabank, Texas 75156
 

                         Please print this form, complete, sign it and fax or mail to>>>

                            

 

                                                                                       APPLICATION FOR CREDIT

 

BUSINESS INFORMATION:

Business Name:  ______________________________________________________ Contact: ________________________

Business Structure: Corp  _____   S Corp  _____      Partnership  _____ Sole Proprietorship ______

Address: _____________________________________________________________________________________________  

City: ___________________________________     State: ____________________________                    Zip: __________________

Time in Business: __________ Years  ________ Months  

Phone Number: ______________________________                            Fax Number:  ________________________________

 

VENDOR/SELLER OF EQUIPMENT:

Name of Company:  American Payment Exchange LLC (APEX) ___________________________________________________  

Contact:  _Jim Paullus______________ Phone Number:  _903-451-9590_________ Fax Number: _903-451-9560____

 

EQUIPMENT DESCRIPTION:  _____________________________________________________________________ Equipment Cost $______________

New or Used: ______ ________                      Term Requested: ___________                       Purchase Option:  __________

 

OWNERSHIP or MAJOR STOCKHOLDER:

Name:  __________________________________________________             Phone #: _____________________________

Social Security Number:  ___________________________________                               Date of Birth: _________________________

Address:  ________________________________________________             Title: ________________________________

Co-Owner/Partner/Additional Stockholder

Name: ___________________________________________________            Phone #: _____________________________

Social Security Number: ____________________________________                              Date of Birth: _________________________

Address: ________________________________________________                              Title: ________________________________

 

BANK INFORMATION:

*Name of Bank: ___________________________________________

Phone Number: ___________________________________________                              Contact: _____________________________

Account Number: __________________________________________

Name of Bank: ____________________________________________

Phone Number: ___________________________________________                              Contact:  ____________________________

Account Number: __________________________________________

 

PREVIOUS CREDIT: (Financed Equipment, Leases, or Installment Loans)

Name of Company: ________________________________________                              Contact: _____________________________

Phone Number:  ___________________________________________             Account #: ___________________________

Name of Company: _______________________________________                 Contact: _____________________________

Phone Number:  __________________________________________                               Account #: ___________________________

 

TRADES: (Where you buy on terms)

*Name of Company: _______________________________________                               Phone #: ____________________________

*Name of Company: _______________________________________                               Phone #: ____________________________

*Name of Company: _______________________________________                               Phone #: ____________________________

 

LANDLORD or MORTGAGE:

Name of Company: ________________________________________                              Phone #: ____________________________

Assignment: All lease applications for credit are assigned to Sutton Funding, Inc. dba American Funding for credit review and processing.  All credit reviews, decisions, actions; processing, etc. will be at the discretion and authority of American Funding and its network of lenders.  American Funding is an independently owned business entity and shares no business ownership relationship with American Payment Exchange LLC (APEX whatsoever.  American Funding is a leasing referral source only for American Payment Exchange LLC. 

Signing: By signing below, the undersigned individual who is either a principal or sole proprietorship of this credit applicant or a guarantor of it’s obligations, provides this written instruction to American Funding, it’s nominees or assigns, authorizing review of his/her personal credit profile from a national credit bureau.  Such authorization shall extend to obtaining a credit profile in consideration of this application and subsequently for the purpose of update, renewal or the extension of such credit or additional credit or for reviewing and collection the result account.  I also authorize the release of credit information and request all loan, credit, bank, trade, and other history be given as needed to American Funding or it’s designee.  I also understand that the use of a photo static or facsimile copy of this authorization shall be valid as the original and may be necessary to verify my history. I/We affirm our Identity as the respective individuals identified in the related application.  I/we also affirm that I/we acknowledge that American Funding will earn a fee for the placement and approval of this request.

 

BY: _______________________________________________ Title: _____________________Date:_____________