WORKING CAPITAL CREDIT APPLICATION

WORKING CAPITAL CREDIT APPLICATION


Type of Business
Corporation LLC Partnership
Non-Profit Sole-Proprietor
Is this a medical practice? *
Yes No
Equipment Condition
New Used
Would you like to secure an additional approval for other equipment or working capital? *
Yes No
How many principals, officers, partners or guarantors do you have? *
1 2 3 4 5
Gender
Male Female
By signing below, each of the above-listed Business Owner(s)/Officer(s)/Principal(s) and Business (individually and collectively, "You") certify that all information and documents submitted in connection with this Funding Application ("Application") are accurate, true, correct and complete; and that You will immediately notify Blue Tree Funding ("Blue Tree") or any of its representatives, successors, assigns, designees, agents, partners or affiliates ("Recipients") of any change in such information or financial condition. You further authorize Blue Tree or Recipients to obtain consumer or personal, business and investigative reports, references and other information about You, including, but not limited to credit card processor statements and bank statements, from one or more consumer reporting agencies, such as TransUnion, Experian, and Equifax, and from other credit bureaus, banks, financial institutions, creditors and other third parties, now or in the future. You also authorize Blue Tree to transmit this Application, along with any of the foregoing information obtained in connection with this Application, to any or all of the Recipients for the foregoing purposes. You agree to adopt this typed electronic representation of your name as your signature and shall be valid as the original. You consent and agree to receive updates from Blue Tree and/or assignees regarding this account via the telephone or fax numbers or email address provided in connection with this or any future application *
Yes - I agree *
 
Blue Tree Funding LLC is committed to protecting your information and respecting your privacy. Information submitted via this form will only be used to evaluate as a credit application. This form and submissions are private and secure with High-grade 256-bit SSL encryption. This is not an approval. A decision with the contract terms and conditions will be based on review of the credit application and subject to underwriting requirements.