Application Form

No Impact to Your Credit Score

First, Tell us about the equipment.

What would you like to finance?

Is the equipment new or used?

New Used

What is the cost of the equipment?

Who is the vendor?

What is the vendor's number?

Now, please tell us about your business.

Company legal name

DBA (If applicable)

What does your business do?

Federal ID

Address

Contact name

Contact email

Contact phone

Company Structure

In business since:

State of incorporation

Next, let's learn a bit more about you.

Name

Social security number

Phone number

Same address as my Business address

Yes No

Home Adress

Ownership percentage

Finally, is there a second owner?

Yes No

Name

Social security number

Phone number

Ownership percentage

Home address

Please upload any supporting documents

- For applications over $100,000, we suggest uploading the last 3 months's full business bank statements.

I certify that all the above information is true and correct and hereby authorize all of my credit and haul/employment references to release any information requested. I hereby authorize H&M Financial Corp and/or its assignees to verify any and all credit information, including, but not limited to banks, trade and credit reports.

I authorize to submit my information