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TERMS
*
Indicates required field
Amount to Finance
*
Desired Term
*
Select Desired Term
Working Capital
Equipment Financing
Enter the desired term you want to finance
Equipment Description
*
Enter the Equipment description you want to finance
BUSINESS INFORMATION
Business Name
*
Business Address
*
Line 1
Line 2
City
State
Zip Code
Country
Time in Business
*
Select Time in business
Less Than 2 Years
2-4 Years
4-6 Years
6 Years or Greater
Select how many years your business has been established
Legal Structure
*
Select Business Structure
Sole Proprietor
LLC
S- Corp
C-Corp
Partnership
Number of Employees
*
OWNERSHIP
Principal #1
Name
*
First
Last
Email
*
Phone Number
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Social Security Number
*
% Ownership
*
Principal #2 (If Applicable)
Name
*
First
Last
Email
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Phone Number
*
Social Security Number
*
% Ownership
*
SIGNATURES
Application Terms
. This is an electronic financing Application. Submission of this Application shall have the same force and effect as if signed and delivered by the "Customer" and "Principal Owner(s)" identified in this Application. The Vendor submitting this Application on behalf of the Customer represents and warrants to LiquidityOne.Com ("LQ1") that: (a) the information contained in this Application is true, correct and complete; (b) the financing is intended solely for business and commercial purposes; (c) the Customer and Principal Owner(s) identified in this Application have expressly authorized the Vendor to submit this Application and expressly authorize LQ1 and its funding referral sources to obtain consumer credit reports and other information about them from any business or consumer reporting agency or other sources that provide credit reports and scores, account history information, credit and employment history or similar information, and to disclose all of the foregoing information to the Vendor and to LQ1, and such authorization extends to obtaining updated information from time to time for purposes of servicing or collecting Customer's account; (d) Vendor has communicated to the Customer that based upon such information and other factors, LQ1 or its assignee or funding referral source may in their sole discretion grant or decline to grant credit to Customer; (e) the Customer has expressly consented to receiving communications, offerings and updates from LQ1 and its partners regarding Customer's account via the telephone, fax and mobile device numbers and the email address provided in this Application; and (f) Vendor agrees to indemnify and defend LQ1 for any claims or actions by Customer and/or Principal Owner(s) arising from Vendor's breach or nonfulfillment of any of Vendor's reps, warranties or agreements contained in these Application Terms.
Principal 1 First/Last Name
*
Date (mm/dd/yyyy)
*
Principal 2 (If Applicable) First/Last Name
*
Date (mm/dd/yyyy)
*
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