If you prefer to fill out this application by hand, download it by clicking here:
https://www.unitedliftfinancing.com/United-Lift-Holdings-App.pdf

Email: salesteam@unitedliftequipment.com
Fax: 800-616-4981
Phone: 800-279-5890
Credit Application - All Owners Must Be Disclosed
Business Information
Business Type:                                   
Legal Business Name:
 D/B/A:
Nature of Business:
 Federal ID#:
 Time In Business:
Mailing/Business Address:
 City:
 State:
 Zip:
 County:
Business Phone:
Ext. 		Business Fax:
 Cell:
Website:
 Location Where Equipment Is Kept (If Different From Above):
Annual Revenue:
 # of Employees:
 Date of Incorporation:
 State of Incorporation:
 Business Start Date:
Guarantor 1
Full Name:
 Title:
 Social Security #:
 % Owned:
 Date of Birth:
 Home Address:
Home Phone:
 Cell Phone:
 Email:
 Are You A Homeowner?
Have you ever filed for bankruptcy protection?
 If yes, what was the discharge date?
 Country of Citizenship:
Guarantor 2 (This box not required if you are the SOLE OWNER/RESPONSIBLE PERSON FOR THIS LOAN)
Full Name:
 Title:
 Social Security #:
 % Owned:
 Date of Birth:
 Home Address:
Home Phone:
 Cell Phone:
 Email:
 Are You A Homeowner?
Have you ever filed for bankruptcy protection?
 If yes, what was the discharge date?
 Country of Citizenship:
Guarantor 3 (This box not required if you are the SOLE OWNER/RESPONSIBLE PERSON FOR THIS LOAN)
Full Name:
 Title:
 Social Security #:
 % Owned:
 Date of Birth:
 Home Address:
Home Phone:
 Cell Phone:
 Email:
 Are You A Homeowner?
Have you ever filed for bankruptcy protection?
 If yes, what was the discharge date?
 Country of Citizenship:
Bank / Money Market Accounts
Bank Name:

 Account #:

 Telephone #:

 Contact Person:
Business Loan References
Name:

 Account #:

 Telephone #:

 Contact Person:
Vendor/Equipment Information
Vendor:
United Lift LLC 		Address:
500 Commerce Drive, Suite 2 		City, State, Zip:
Amherst, NY 14228 		Equipment Sale Price:
Contact:
Sales Department 		Phone:
800-279-5890 		Fax:
800-616-4981 		Email:
salesteam@unitedliftequipment.com 		Finance Request:

Year:
 Make:
 Model:
 Description:
 VIN/Serial:
 Delivery Date:
As soon as
payment is received
Signature
I hereby authorize you to whom this application is made, or your agents, to investigate my/our credit worthiness and will provide financial statements, tax returns, etc., as you deem necessary. I/we agree that any security deposit paid is not refundable unless the application is rejected. By the execution of any lease/loan agreement, I/we warrant that the information submitted herein is true and correct and hereby authorize references contained herein to release any necessary information. Further, I/we warrant that it is understood that Creditor reserves the right to reverse any credit decision if the information contained herein is found to be incorrect, or for any other reason, and I/ we will indemnify Creditor for any and all costs incurred with this application for credit including any cost incurred in the placement or reservation of the intended equipment based on the information contained herein.
x x x
Guarantor 1 Signature Guarantor 2 Signature Guarantor 3 Signature
BY CHECKING THIS BOX AND TYPING NAME ABOVE, I/WE ELECTRONICALLY SIGN THE APPLICATION