Application – Juice Bar Of The Future

Credit Application

Fill out the from below to apply for financing through Marlin Capital Solutions.

We provide commercial financing and you must have an active business with a Fed Tax ID #.

1 Company Info

2 Software/Equipment

3 Owners, Partners or Guarantors

4 Bank Info

5 Trade Reference

6 Signature

Customer Information
May we contact customer if additional information is needed?*
- Yes
- No
Referred By
First Name*
Last Name*
Email Address*
Phone Number*
Fax Number
Contact*
Address*
Street Address City State ZIP Code
Web Address*
State of Incorporation/Organization
Full legal business name*
Nature of Business
Federal Tax ID #*
Number of Employees
Years in Business*
Years of Ownership*
Legal business address*
Street Address City State ZIP Code
Type of Business*
- Proprietorship
- Partnership
- Corporation
- Limited Liability Corp.

Software/Equipment Being Financed
(Include quantity, make, model, serial number and accessories)
Check here if equipment is used
Software/Equipment Location (if different):
Equipment being financed*
Equipment cost*
Equipment cost*
Equipment location address*
Street Address City State ZIP Code

OWNERS, PARTNERS, OR GUARANTORS
How many owners, partners or guarantors?*
Person 1 Information
Name*
First Last
Title
SS#*
Address*
Street Address City State ZIP Code
Phone
Person 2 Information
Name*
First Last
Title
SS#*
Address*
Street Address City State ZIP Code
Phone
Person 3 Information
Name*
First Last
Title
SS#*
Address*
Street Address City State ZIP Code
Phone
Person 4 Information
Name*
First Last
Title
SS#*
Address*
Street Address City State ZIP Code
Phone
Person 5 Information
Name*
First Last
Title
SS#*
Address*
Street Address City State ZIP Code
Phone
Person 6 Information
Name*
First Last
Title
SS#*
Address*
Street Address City State ZIP Code
Phone
Person 7 Information
Name*
First Last
Title
SS#*
Address*
Street Address City State ZIP Code
Phone
Person 8 Information
Name*
First Last
Title
SS#*
Address*
Street Address City State ZIP Code
Phone
Person 9 Information
Name*
First Last
Title
SS#*
Address*
Street Address City State ZIP Code
Phone
Person 10 Information
Name*
First Last
Title
SS#*
Address*
Street Address City State ZIP Code
Phone

Bank Information
How many banks?*
Bank 1 Information
Name of Bank
Bank Officer
Phone
Deposit/Check Acct #
Loan Acct #
Bank 2 Information
Name of Bank
Bank Officer
Phone
Deposit/Check Acct #
Loan Acct #
Bank 3 Information
Name of Bank
Bank Officer
Phone
Deposit/Check Acct #
Loan Acct #
Bank 4 Information
Name of Bank
Bank Officer
Phone
Deposit/Check Acct #
Loan Acct #
Bank 5 Information
Name of Bank
Bank Officer
Phone
Deposit/Check Acct #
Loan Acct #

Trade Reference
Name of Supplier
Contact
Phone
Address*
Street Address City State ZIP Code

Signature
The parties agree that this agreement may be electronically signed. The parties agree that the electronic signatures appearing on this agreement are the same as handwritten signatures for the purposes of validity, enforceability, and admissibility. You may withdraw your consent to receive electronic documents, notices or disclosures at any time. In order to withdraw consent, you must notify the sending party that you wish to withdraw consent and request that your future documents, notices and disclosures be provided in paper format. To request paper copies of documents; withdraw consent to conduct business electronically and receive documents, notices or disclosures electronically; or withdraw consent to sign documents electronically, please contact the the sending party by telephone, postal mail or email. The foregoing shall be governed according to the laws of the state of California.
Signature Name*
Date*
Date Format: MM slash DD slash YYYY
Name
This field is for validation purposes and should be left unchanged.

[email protected]

Credit Application

Customer Information

Software/Equipment Being Financed

OWNERS, PARTNERS, OR GUARANTORS

Bank Information

Trade Reference

Signature