equipment financing and construction financing industry. Forke Florida, Georgia, Kentu

ON-LINE APPLICATION Company Name: E-mail Address: Address: City: State: ZIP Code: County: Legal Form: Corporation Partnership Sole Proprietorship Tax ID Number: Business Phone: ( ) Ext. Business Fax: ( ) Annual Revenues: Number of Years in Business (min. 5): Type of Business: Number of units of equipment currently owned: Bankruptcy: Yes No If Yes, explain Credit Request Specific: Purchase Refinance Auction Line Requested Term: 24 Months 36 Months 48 Months 60 Months Amount Requested: Equal monthly installments? Yes No If no, explain Please describe the equipment you wish to finance Quantity Year: Make: Model: Description: Serial number/VIN Seller Quantity Year: Make: Model: Description: Serial number/VIN Seller Quantity Year: Make: Model: Description: Serial number/VIN Seller Quantity Year: Make: Model: Description: Serial number/VIN Seller Principals SSN (Principals): Percent of Ownership: Name: Last First Middle Address: City: State: Personal Bankruptcy: Yes No If Yes, explain SSN (Principals): Percent of Ownership: Name: Last First Middle Address: City: State: Personal Bankruptcy: Yes No If Yes, explain SSN (Principals): Percent of Ownership: Name: Last First Middle Address: City: State: Personal Bankruptcy: Yes No If Yes, explain Bank References Name: City: State: Phone: ( ) Contact: Savings: How long have you been a customer? Loan: Highest Credit Extended: Current balance of open loans: Have all loans been paid as agreed? Yes No If no, explain Equipment Loan References Name: City: State: Account Number: Contact: How long have you been a customer? Highest credit extended: Current balance of open loans: Have all loans been paid as agreed? Yes No If no, explain Name: City: State: Account Number: Contact: How long have you been a customer? Highest credit extended: Current balance of open loans: Have all loans been paid as agreed? Yes No If no, explain Name: City: State: Account Number: Contact: How long have you been a customer? Highest credit extended: Current balance of open loans: Have all loans been paid as agreed? Yes No If no, explain

"Borrowing money is never a pleasant experience. But the people at FCC Equipment Financing are willing to take the time to explain things to you and make you feel more comfortable with them and your financial decision." Nancy Sparks President Sparks Crane Service, Inc. Pinellas Park, FL

About FCC | Products & Services | Auction Department | Credit Application | Information Resources | Contact Us | Local FCC Reps | © 2003 FCC Equipment Financing Inc. All rights reserved. | Call us toll-free: 800-207-9286

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ent Financing is built upon the best exprience in the heavy equipment financing and construction financing industry. Forke Florida, Georgia, Kentucky, Louisiana, Mississippi, Vermont, Washington, North Carolina, South Carolina, Alabama, California, New Mexico, Arizona, Utah, North Dakota, South Dakota, Texas, Oklahoma, New York, Wisconsin, Missouri, Kansas, Idaho, Maine, Maryland, Minnesota, Alaska, Nebraska, Montana, Wyoming, Pensylvania

, Indianna, Illinois, Virginia, West Virginia, Tennessee, Michigan, New Hampshire, Massachusetts, Connecticut. FCC Equipment Financing is built up

on the best experience in the heavy equipment financing and construction financing industry. Forke Florida, Georgia, Kentucky, Louisiana, Mississippi, Vermont, Washington, North Carolina, South Carolina, Alabama, California, New Mexico, Arizona, Utah, North Dakota, South Dakota, Texas, Oklahoma, New York, Wisconsin, Missouri, Kansas, Idaho, Maine, Maryland, Minnesota, Alaska, Nebraska, Montana, Wyoming, Pensylvania, Indianna, Illinois, Virginia, West Virginia, Tennessee, Michigan, New Hampshire, Massachusetts, Connecticut.