Thank you for chosing to finance your machine tool. Please print out this application, completely fill out this application, and fax it to the Atrump Dealer or financial institution of your choice. If you do not have a financial institution in mind, here are some that ATRUMP has worked with and recommend:
 
National Equipment Lease - Brenda Osborne           Tel: 904-573-3729      Fax: 904-573-3834
De Lage Laden Financial Services - Patrick Burke   Tel: 1-800-800-4455   Fax: 1-800-733-7226
Intech Funding Corp. - Chuck Farmer                          Tel: 1-800-553-3208   Fax: 1-800-553-9192
 
Atrump Machinery, Inc.
670 Union Avenue Pomona, CA 91768
1-877-4-ATRUMP (428-7867)
Business Information
Business Name
 
Telephone
 
Street Address
 
Fax
 
City/State/Zip
 
Contact Person
 
Type of Business
 
Business Start Date
 
Years Under Current Ownership
Fed. Tax I.D.
 
Proprietorship    Partnership    C-Corp    S-Corp  LLC    Non-Profit 
E-Mail Address
 
Location of Equipment (Street/City/State/Zip)
 
State of Formation
 
Any unsettled lawsuits, judgments, disputes or outstanding tax obligations?    Yes      No 
Bankruptcy ever filed by business?     Yes      No     When?
Annual Sales
$
Bank Information
Bank
 
Contact
 
Phone
 
Type
 
Date Opened
 
Bank
 
Contact
 
Phone
 
Type
 
Date Opened
 
Credit References
Loan/Leasing Company
 
Contact
 
Phone
 
Start Date (Month/Year)
 
Original Loan/Lease Amount
$
Term
 
Monthly Payment
$
Account Number
 
Loan/Leasing Company
 
Contact
 
Phone
 
Start Date (Month/Year)
 
Original Loan/Lease Amount
$
Term
 
Monthly Payment
$
Account Number
 
Trade References
Company Name
 
Contact
 
Phone
 
Company Name
 
Contact
 
Phone
 
Ownership/Guarantor Information
Full Name
 
Title
 
% Of Ownership
 
Social Security Number
 
Home Phone
 
Mobile Phone
 
Email Address
 
Own 
Rent 
How Long
 
Home Address
 
Birthdate
 
Bankruptcy Filed?
Yes  No 
Full Name
 
Title
 
% Of Ownership
 
Social Security Number
 
Home Phone
 
Mobile Phone
 
Email Address
 
Own 
Rent 
How Long
 
Home Address
 
Birthdate
 
Bankruptcy Filed?
Yes   No 
Equipment Information     ***Attach Invoice***
Vendor
 
Contact
 
Phone
 
Fax
 
Equipment
 
New 
Used 
Price W/O Tax
$
Preferred Term
 
Preferred Lease/Loan Structure
 
Preferred Advance Payments
 
Preferred Residual
 
By signing below, the undersigned individual, who is either a principal of the credit applicant and/or a personal guarantor of its obligations, provides written instruction to Atrump Machinery or its designee (and any assignee or potential assignee thereof) authorizing review of his/her personal credit profile from a national credit bureau. Such authorization shall extend to obtaining a credit profile in considering this application and subsequently for the purposes of update, renewal or extension of such credit or additional credit and for reviewing or collecting the resulting account. A photostat or facsimile copy of this authorization shall be valid as the original. Undersigned further authorizes release of all bank information for personal and corporate accounts by phone or fax. By signature below, I/we affirm my/our identity as the respective individual(s) identified in the above application.
 
Signed                                                                                                                   Title                                        Date                                                      
 
Signed                                                                                                                   Title                                        Date                                      

Atrump Machinery, Inc.