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NuCorp Account Executive
 
Vendor Info
Equipment Vendor Name: Salesperson:
Equipment Description: Office Number:
Equipment Cost: Requested Term (24/36/48/60 months):
 
 
Company Info
Company Name:    
Company Address: City/State/Zip:
Business Industry: Office Number:
Email Address : Fax Number :
Type of Business: Number of Years in Business:
Federal Tax ID (if applicable) : D & B (if applicable) :
Signer Name: Title:
 
 
Principal 1
Name of Principal 1: Title:
Social Security Number: Home Phone Number:
Home Address: City/State/Zip:
Principal 2 (if applicable)
Name of Principal 2: Title:
Social Security Number: Home Phone Number:
Home Address: City/State/Zip
 
 
Additional Info:

By clicking the "Submit" button, you confirm that you have read and agree to the "Terms & Conditions" stated below.



Terms & Conditions

The above information, together with any accompanying financial statements, schedules, or other materials, is submitted for the purpose of obtaining credit and is warranted to be true, correct, and complete. The undersigned hereby warrants that any individual identified above who is either a principal, a personal guarantor, or a sole proprietor of the credit applicant, recognizing that his or her individual credit history may be a factor in the evaluation of the credit history of the applicant, has provided his/her written authorization for inquiry into their credit worthiness, including but not limited to obtaining a consumer credit report, and shall hold NuCorp Financial Services and its assignees harmless from same. NuCorp financial Services is hereby authorized to investigate (directly or through an agent or nominee) your/their credit and financial responsibility. You understand that such investigation may include seeking information as to the background, credit, and financial responsibilities of your officers and principals (or any of them).

The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national origin, sex, marital status or age (provided applicant has the capacity to enter into the binding contract); because all or part of the applicant’s income derives from any public assistance program; or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act. If for any reason your application for business credit is denied, you have the right to a written statement of the specific reasons for the denial. To obtain the statement, please write to: NuCorp Financial Services, 26030 Acero, Mission Viejo, CA, 92691.
 

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