Secure Business Credit Application

Customer Information

Company Name*

Company Type* Corporation Partnership Sole Proprietor

Billing Address*

Equipment Address (If different)

City*

State*

Zip*

Phone*

Fax

Email*

Nature of Business*

Years in Business*

Principal 1

First Name*

Last Name*

Title*

Ownership %*

Home Address*

City*

State*

Zip*

Social Security*

Phone*

Add a 2nd principal

Principal 2

First Name

Last Name

Title

Ownership %

Home Address

City

State

Zip

Social Security

Phone

Equipment / Project

Description

Estimated Project Start Date (in days) 30 60 90 90+

Total Equipment Cost $

Total Construction Cost $

Total Project Cost $

Vendor/Supplier of Equipment

Vendor Contact

Vendor Phone

Additional Information

Other information you would like us to know

* Required Field By clicking the Submit Application button, I hereby authorize Harbour Capital, its designees or assigns to make business and or personal credit inquiries as necessary for this Credit Application or any related lease or equipment finance agreement. I understand that this may include a personal credit bureau which will be used in the credit evaluation process of this or another credit application. I also authorize Harbour Capital or its designees or assigns to obtain or review bank, financial or other information from creditors or potential creditors. A copy, electronic, or facsimile signature(s) shall have the same force and effect as an original signature(s). I also authorize Harbour Capital, its designees or assigns to contact me via any means or media deemed necessary.