Application - Blue Tree Funding

Step 1 of 4

Office Information
Business Name
DBA
Billing Address
Street Address Address Line 2 City State ZIP Code
Physical Address
Same as Billing
Street Address Address Line 2 City State ZIP Code
Equipment Address
Same as Billing
Street Address Address Line 2 City State ZIP Code
County
Business Phone
Business Fax
Contact Name
First Last
Contact Cell
Nature of Business
Entity Type
State of Incorporation
Federal Tax ID
State / UBI #
Business Start Date
Years Owned
Email
Business Website

Officers / Owners / Partners / Members Guarantor Information
Guarantor 1 - Name
First Last
Guarantor 1 - Title
Guarantor 1 - SSN
Guarantor 1 - Date of Birth
Guarantor 1 - Phone
Guarantor 1 - Address
Street Address Address Line 2 City State ZIP Code
Guarantor 1 - Email
Guarantor 1 - Ownership %
Please enter a number from 0 to 100.
Guarantor 2 - Name
First Last
Guarantor 2 - Title
Guarantor 2 - SSN
Guarantor 2 - Date of Birth
Guarantor 2 - Phone
Guarantor 2 - Address
Street Address Address Line 2 City State ZIP Code
Guarantor 2 - Email
Guarantor 2 - Ownership %
Please enter a number from 0 to 100.
Guarantor 3 - Name
First Last
Guarantor 3 - Title
Guarantor 3 - SSN
Guarantor 3 - Date of Birth
Guarantor 3 - Phone
Guarantor 3 - Address
Street Address Address Line 2 City State ZIP Code
Guarantor 3 - Email
Guarantor 3 - Ownership %
Please enter a number from 0 to 100.
Guarantor 4 - Name
First Last
Guarantor 4 - Title
Guarantor 4 - SSN
Guarantor 4 - Date of Birth
Guarantor 4 - Phone
Guarantor 4 - Address
Street Address Address Line 2 City State ZIP Code
Guarantor 4 - Email
Guarantor 4 - Ownership %
Please enter a number from 0 to 100.

Additional Locations (if applicable)
Additional Location 1 - Name
Additional Location 1 - Phone
Additional Location 1 - Years in Business
Additional Location 1 - Contact
Additional Location 2 - Name
Additional Location 2 - Phone
Additional Location 2 - Years in Business
Additional Location 2 - Contact

Equipment to be Leased and Vendor/Supplier Information
Equipment Description
Requested Financing Amount
Lease Term Requested
Special Requirements
Vendor 1 Name
Vendor 1 Phone
Vendor 2 Name
Vendor 2 Phone
Vendor 3 Name
Vendor 3 Phone