Applying For

Lease/Finance
Working Capital
Both

Step 1: Company Information
Step 2: Customer Information
Step 3: Equipment Information

Step 1: Company Information
- New Company
- Existing Company

Legal Company Name *
Operating Name (DBA) *
Business Type *
Years In Business * *
Nature of Business *
Physical Address *
City *
State *
ZIP Code * *
Business Phone * * Ext.
Business Fax *
Average Annual Revenue * *
Average Bank Balance * *
Federal Tax ID *

Step 2: Customer Information
Principal 1
- - New Contact
  - Existing Contact
- First Name *
- Middle Name *
- Last Name *
- Job Title *
- Percent of Ownership * * *
- Same as Business Addr.?
  - Yes
  - No
- Home Address *
- City *
- State *
- ZIP Code * *
- Home Phone * *
- Mobile Phone * *
- Email Address * *
- Social Security Number * *
- Date of Birth * *
- Home Ownership *
  - Own
  - Rent
- Value of Home * *
- Mortgage Balance * *
- Outstanding Judgements or Legal Proceedings? *
  - No
  - Yes
Principal 2
- - New Contact
  - Existing Contact
- First Name *
- Middle Name *
- Last Name *
- Job Title *
- Percent of Ownership * * *
- Same as Business Addr.?
  - Yes
  - No
- Home Address *
- City *
- State *
- ZIP Code * *
- Home Phone * *
- Mobile Phone * *
- Email Address * *
- Social Security Number * *
- Date of Birth * *
- Home Ownership *
  - Own
  - Rent
- Value of Home * *
- Mortgage Balance * *
- Outstanding Judgements or Legal Proceedings? *
  - No
  - Yes
Principal 3
- - New Contact
  - Existing Contact
- First Name *
- Middle Name *
- Last Name *
- Job Title *
- Percent of Ownership * * *
- Same as Business Addr.?
  - Yes
  - No
- Home Address *
- City *
- State *
- ZIP Code * *
- Home Phone * *
- Mobile Phone * *
- Email Address * *
- Social Security Number * *
- Date of Birth * *
- Home Ownership *
  - Own
  - Rent
- Value of Home * *
- Mortgage Balance * *
- Outstanding Judgements or Legal Proceedings? *
  - No
  - Yes
Principal 4
- - New Contact
  - Existing Contact
- First Name *
- Middle Name *
- Last Name *
- Job Title *
- Percent of Ownership * * *
- Same as Business Addr.?
  - Yes
  - No
- Home Address *
- City *
- State *
- ZIP Code * *
- Home Phone * *
- Mobile Phone * *
- Email Address * *
- Social Security Number * *
- Date of Birth * *
- Home Ownership *
  - Own
  - Rent
- Value of Home * *
- Mortgage Balance * *
- Outstanding Judgements or Legal Proceedings? *
  - No
  - Yes
Principal 5
- - New Contact
  - Existing Contact
- First Name *
- Middle Name *
- Last Name *
- Job Title *
- Percent of Ownership * * *
- Same as Business Addr.?
  - Yes
  - No
- Home Address *
- City *
- State *
- ZIP Code * *
- Home Phone * *
- Mobile Phone * *
- Email Address * *
- Social Security Number * *
- Date of Birth * *
- Home Ownership *
  - Own
  - Rent
- Value of Home * *
- Mortgage Balance * *
- Outstanding Judgements or Legal Proceedings? *
  - No
  - Yes
Principal 6
- - New Contact
  - Existing Contact
- First Name *
- Middle Name *
- Last Name *
- Job Title *
- Percent of Ownership * * *
- Same as Business Addr.?
  - Yes
  - No
- Home Address *
- City *
- State *
- ZIP Code * *
- Home Phone * *
- Mobile Phone * *
- Email Address * *
- Social Security Number * *
- Date of Birth * *
- Home Ownership *
  - Own
  - Rent
- Value of Home * *
- Mortgage Balance * *
- Outstanding Judgements or Legal Proceedings? *
  - No
  - Yes

Step 3: Equipment Information
Equipment Description *
Vendor Contact Email * *
Estimated Equipment Cost * *
Equipment Status *
- New
- Used
Equipment Titled *
- Yes
- No
Equipment Year * *
Working Capital Amount * *
Budgeted Monthly Payment * *
Time Frame *
Comments *
Please note that you will be able to upload any attachments you wish to include after the initial submission.
By checking this box, I agree with the Terms of Use and Privacy Policy. *
By clicking "submit" below, the undersigned individual, who is either a principal of the credit applicant or a personal guarantor of its obligations, provides written instruction to Lessor or its designee (and any assignee or potential assignee thereof) authorizing review of his/her personal credit profile from a national credit bureau, as well as obtaining bank and/or other credit information as required. Such authorization shall extend to obtaining a credit profile in considering this application subsequently for the purposes of update, renewal or extension of such credit or additional credit and for reviewing or collecting the resulting account. A electronic, photostat or facsimile copy of this authorization shall be valid as the original. By clicking "submit" below, I/we affirm my/our identity as the respective individual/s identified in the application received. *

Processing...

Thank you for submitting your application. We look forward to working with you. Please expect a sales executive to contact you shortly.
Lease Reference Number:
Working Capital Reference Number:
Attachments
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For questions regarding finance, please contact: Jermain Long Phone: 610-592-699 Email: jlong@premierfinancing.com

For technical support, please contact: Ivan Rosillo Phone: 714-787-1336 Email: Ivan@AnuvaCapital.com

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January 14, 2025