HTML Preview Business Lease Credit Application Form page number 1.
Retail
Lease
DEALER NAME
Corporation
Legal Business Name
Physical Address
Billing Address (if other than above)
Garage Address (if other than above)
State of Organization
Principal Name (1) Address Title % Ownership
Principal Name (2) Address Title % Ownership
Principal Name (3)
Vehicle Fleet Management Contact
Address (including city, state, zip)
Individual (First Name, Middle Initial, Last Name, Generation)
Present Address: (Number and Street)
City State Zip Code
Home Phone
()
Own/Buying
Rent/Lease
Living with Relative
Other
Lived There
______ Yrs. ______ Mos.
Driver’s License No. & State
Alternate Phone (Cell, Pager)
( )
Employer Name & Address Main Business #
( )
Time on Job
______ Yrs. ______ Mos.
Previous Employer/Business (if less than 2 years)
()
Employer Name & Address Phone Number
()
Time on Job
______ Yrs. ______ Mos.
Monthly Income
$
Secondary Income
$
Source Gross Monthly Income from Business
$
Alimony, child support or separate maintenance income need not be revealed
if you do not wish to have it considered as a basis for repaying this obligation.
Mortgage Holder/Landlord (Name & Address) Contact Monthly Payment
$
Phone
()
Phone
( )
Phone
()
Phone
( )
Phone
()
Phone
()
Bank Name and Address Checking Account #
Savings Account #
Nearest Relative (Not living with you) Relationship Address
Personal Reference Relationship Address
Personal Reference Relationship Address
Personal Reference
Company: X
By:
Title:
RETAIL
SALES PRICE $
DOWN PAYMENT $
NET TRADE $
AMOUNT FINANCED $
PROGRAM
TERM
NET LEASE
GROSS CAP $
REDUCTION $
ADJUSTED CAP $
MSRP $
PROGRAM
PAYMENT $ TERM
LINE REQUEST $
# OF VEHICLES IN FLEET
All line requests over $250,000 require 2 previous year-end
CPA reviewed/audited financial statements or accountant
prepared tax returns and current YTD interim statements.
VIN:
NEW INVOICE $ TRADE IN:
USED VALUE GUIDE:
DEMO USED VALUE $
YEAR YEAR
MAKE MAKE
MODEL MODEL
TRAC LEASE
GROSS CAP $
REDUCTION $
ADJUSTED CAP $
TERM
RESIDUAL %
PAYMENT $
MONEY FACTOR
X
SIGNATURE OF GUARANTOR DATE
Relationship
Date
Address
Social Security No. Date of Birth
Title Phone
( )
Email
If more than three Principals, Please attach separate sheet listing information.
Address Title % Ownership
City
City
Email Address
State
State
Primary Driver Name
Trade Name/DBA/Parent Company
Zip Code
Zip Code
Phone
( )
Phone
()
Phone
( )
Phone
( )
Tax ID Number
Type of Business
Year-End PBT
$
Website Address
Financial Statement Type*Date Bus. Estab.
C
S
Bank and Auto Financing or Other Credit Sources
PROPOSED FINANCING TERMS SINGLE UNIT VEHICLE DESCRIPTION
CREDIT LINE REQUEST
Financial Institution Address Acct. No. Unpaid Balance Contact Phone
NMAC 2008 1/08
DEALER INFORMATION
BUSINESS INFORMATION
GUARANTOR OR SOLE PROPRIETORSHIP
SIGNATURE
DEALER
PLEASE USE BLACK INK
Proof #15 11/7/07 from New 12/04/06 from Final 04/19/05 9089M5720335
Business Credit Application
LLC
Trust
Non-Profit
Partnership
TRAC
DEALER NUMBER DEALER CONTACT
PROGRAM TYPE:
NOTICE: I, THE UNDERSIGNED, HEREBY AUTHORIZE THE DEALER, NISSAN MOTOR ACCEPTANCE CORPORATION, INFINITI FINANCIAL SERVICES, NISSAN-INFINITI LT AND/OR
(COLLECTIVELY “PROSPECTIVE CREDITORS”), TO VERIFY CREDIT AND EMPLOYMENT HISTORY AS STATED ABOVE AND TO ANSWER
QUESTIONS ABOUT CREDIT EXPERIENCE WITH ME. IF THIS APPLICATION IS MADE PURSUANT TO ANY CREDIT PROGRAM FOR ATTENDEES AND/OR GRADUATES OF SCHOOLS
OR EDUCATIONAL INSTITUTIONS, THEN PROSPECTIVE CREDITORS MAY VERIFY MY ELIGIBILITY FOR SUCH PROGRAM, INCLUDING BY INQUIRY TO MY SCHOOL(S) OR
EDUCATIONAL INSTITUTION(S). INSURANCE RELATED TO THE CREDIT FOR WHICH I AM APPLYING MAY BE PURCHASED FROM AN INSURER OR AGENT OF MY CHOICE WHO
MEETS PROSPECTIVE CREDITOR STANDARDS. IN CONNECTION WITH THIS APPLICATION FOR CREDIT, PROSPECTIVE CREDITORS MAY REQUEST A CREDIT REPORT. ON MY
REQUEST, PROSPECTIVE CREDITORS WILL ADVISE ME IF THE REPORT WAS ACTUALLY ORDERED AND IF SO, THE NAME AND ADDRESS OF THE AGENCY THAT FURNISHED THE
REPORT. PROSPECTIVE CREDITORS MAY ORDER SUBSEQUENT CREDIT REPORTS.
I AUTHORIZE PROSPECTIVE CREDITORS TO ASK MY PAST AND CURRENT CREDITORS (“CREDIT REFERENCES”), INCLUDING CREDITORS LISTED ABOVE OR ON MY CREDIT
REPORT, ABOUT MY CREDIT PERFORMANCE WITH THEM AND TO DISCLOSE TO OTHER PERSONS, INCLUDING CREDIT REPORTING AGENCIES, INFORMATION ABOUT MY
ACCOUNTS AND CREDIT EXPERIENCE. THIS SHALL BE A CONTINUING AUTHORIZATION FOR ALL PRESENT AND FUTURE REQUESTS AND DISCLOSURES. PROVISION BY
PROSPECTIVE CREDITORS OF A COPY OF THIS AUTHORIZATION SHALL SERVE AS MY DIRECTION THAT MY CREDIT REFERENCES PROVIDE MY CREDIT PERFORMANCE
INFORMATION.
EVERYTHING THAT I HAVE STATED IN THIS APPLICATION IS COMPLETE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND CONSTITUTES MY ENTIRE APPLICATION FOR
CREDIT WITH THE PROSPECTIVE CREDITORS. I UNDERSTAND THAT PROSPECTIVE CREDITORS WILL RETAIN THIS APPLICATION WHETHER OR NOT IT IS APPROVED. I WILL
NOTIFY PROSPECTIVE CREDITORS, IF APPLICABLE, WITHIN A REASONABLE TIME OF ANY CHANGE IN MY NAME, ADDRESS OR EMPLOYMENT.
IN STATES WHERE LEASING IS AVAILABLE THROUGH NISSAN-INFINITI LT, NISSAN MOTOR ACCEPTANCE
CORPORATION ACTS AS SERVICER FOR NISSAN-INFINITI LT FOR LEASE APPLICATIONS. INFINITI FINANCIAL
SERVICES IS A DIVISION OF NISSAN MOTOR ACCEPTANCE CORPORATION.
NOTICE TO OHIO APPLICANTS: THE OHIO LAWS AGAINST DISCRIMINATION REQUIRE THAT ALL CREDITORS MAKE CREDIT EQUALLY AVAILABLE TO ALL CREDIT WORTHY CUSTOMERS, AND THAT CREDIT REPORTING
AGENCIES MAINTAIN SEPARATE CREDIT HISTORIES ON EACH INDIVIDUAL UPON REQUEST. THE OHIO CIVIL RIGHTS COMMISSION ADMINISTERS COMPLIANCE WITH THIS LAW.
*Indicate which of the following is applicable
to the financial statement submitted: CPA
Prepared, CPA Reviewed, CPA Audited,
CPA Unaudited, Tax Return, 10K or 10Q.