Credit Application Please fill out the form below or click the button below to download the PDF version. Download our credit application here. CUSTOMER INFORMATION: Full Legal Name of Company Email(Required) Address(Required) Address City State / Province / Region ZIP / Postal Code Phone(Required)FaxCounty Additional Contact NumberFed ID#(Required) Check One(Required) S-Corp. C-Corp. Partnership Sole Prop. Date Business Began(Required) MM slash DD slash YYYY Type of Business(Required) OWNERS: (Individual(s) who own business) 1.Name(Required) Address(Required) Street Address City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code 2.Full Name Address Street Address City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code BANK INFORMATION: (Company Bank(s)) 1:Bank Name(Required) Years Officer Account Type Bank Phone#2:Bank Name Years Officer Account Type Bank Phone#CREDIT REFERENCES: 1:Name Phone2:Name PhoneConsent(Required) I, the undersigned hereby authorize the release of credit information, and request that all loan, credit, bank, trade or other history be given to American Lift & Equipment, Inc. and its assignees.– PLEASE SELECT YOUR PREFERRED EQUIPMENT AND TERMS - EQUIPMENT NEEDS:Equipment Quantity Total Financing Amount Needed DescriptionType of Finance Desired (check one): Purchase Lease Lease/Purchase Terms Desired (check one): 24mo 36mo 48mo 60mo 72mo SPECIAL REQUESTS/REQUIREMENTS:CAPTCHA
