Financing Application

Business Information
Company Name:*
DBA Name:*
Address*
Street Address City State ZIP Code
Phone*
Fax:
Main Contact Email:*
Year Business Started:*
Website (if applicable)
Type of Business:*
- Corporation
- LLC
- Proprietorship
- Partnership
Tax ID:*
Business Description (what does your company do?):*
Equipment Location (if not the address above):
Street Address City State ZIP Code

Equipment Information
Description (What are you looking to finance?):*
New or Used?*
- New
- Used
Requested Term:*
Requested Amount:*
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Vendor Information
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Name:
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Contact
First Last
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Phone
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Website
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Address
Street Address City State ZIP Code

Applicant's Statement & Authorization to Release Bank Information
Consent*
I agree.
We hereby authorize the release of any and all credit information to BankFinancial, National Association (BFIN), and/or its assigns, from the above listed references and certify that all is true and correct to the best of our knowledge. The undersigned individual(s), recognizing that his or her individual credit history may be a factor in the evaluation of the this application, hereby consents to and authorizes BFIN, and/or its assigns, to obtain and use a consumer credit report on the undersigned, now and from time to time, as may be needed in the credit evaluation and review process and waives any right or claim that he/she would otherwise have under the Fair Credit Reporting Act in the absence of this continuing consent. A photocopy, facsimile copy or electronic version of this authorization shall be valid as the original.

Business Information