Credit Application

	Company Information
	Company Name *

	Company Address *

	City *

	State *

	Zip *

	Business Phone *

	Type of Business *

	Personal Information on Offices, Partners, or Guarantors
	Applicant 1
	Full Name

	Job Title *

	Social Security Number *

	% of Ownership

	Home Address *

	City *

	State *

	Zip *

	Home Phone *

	Do You Own or Rent Your Current Residence? *
	Own Rent
	Applicant 2
	Full Name

	Job Title

	Social Security Number

	% of Ownership

	Home Address

	City

	State

	Zip

	Home Phone

	Do You Own or Rent Your Current Residence?
	Own Rent
	Company Bank References
	Name of Bank *

	Opening Date *

	Account Number *

	Phone Number *

	Contact / Officer

	Declaration / Authorization
	The undersign agrees that the information provided above, together with any financial statements, schedules or other materials provided to Paramount Financial Services, LLC, “PFS” is true correct and complete. The undersign authorizes PFS to obtain the credit history of the undersigned and the officers and principals of the Company and to investigate (directly or indirectly) such credit history from any source. The undersign warrants that he or she has never filed for bankruptcy in a personal or business capacity.
	Full Name of Applicant 1 *

	Signature (Type Name) *

	Title *

	Date *

	Full Name of Applicant 2

	Signature (Type Name)

	Title

	Date

	Equipment Information
	Sales Contact

	Equipment Description

	Equipment Cost