Finance Application

For faster decision please complete as much information as possible. All the required (*) information is required to submit the application.

If you prefer to fax your application you may download the PDF Application here and fax to (866)-591-6537  

Equipment Vendor Information

Company you are purchasing equipment from.
If you are not working with an equipment sales rep, list “None"
Enter only numbers

Business Information

If startup business, fill in information you know.
Enter only numbers
MM slash DD slash YYYY

Information on Principals

Principal 1

MM slash DD slash YYYY

Principal 2

If applicable, fill out completely

MM slash DD slash YYYY

The applicant(s) certifies that all information contained in this application, and all attachments hereto, are true and complete to the best of the applicant(s) knowledge, and are made for the purpose of obtaining credit for business purposes, and not for personal or family use. The applicant(s) hereby authorize Adia Capital and any assignee, lender or funding service that may be utilized to obtain and use a consumer credit report on the each Guarantor contained herein, now, from time to time, and at any time in the future, as may be needed in the credit evaluation and review process and waives any right or claim the applicant(s) would otherwise have under the Fair Credit Reporting Act in absence of this continuing consent. The applicant(s) further authorize any bank, financial institution or trade reference to release credit information on the applicant(s) account(s) ACL. and/or its assigns. An electronic, photocopy or facsimile copy of this authorization with a copied, electronic or facsimile signature shall be deemed to be binding, valid, genuine and authentic as an original-signature document for all purposes. A non-refundable documentation fee will be required for the preparation and distribution of lease documents.

Hidden
Hidden
Hidden
Hidden
Hidden
Hidden
This field is for validation purposes and should be left unchanged.
ssl secure