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Car Wash Application

By Eric Peters,2014-05-15 14:23
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Car Wash Application

    Petroleum & Franchise Capital

    VEHICLE WASH FINANCING GROUP

    CREDIT APPLICATION

    BORROWER’S LEGAL NAME:

    BUSINESS ADDRESS: CITY STATE ZIP COUNTY

CORPORATE NAME FOR NEW LOCATION (IF APPLICABLE)

    CITY STATE ZIP COUNTY ADDRESS OF NEW CAR WASH/EQUIPMENT LOCATION:

    CONTACT PHONE NUMBER FAX NUMBER

FEDERAL TAX ID# DATE OF INCORPORATION

    BUSINESS STRUCTURE:

     CORPORATION S-CORPORATION PARTNERSHIP PROPRIETORSHIP PRINCIPAL(S) INFORMATION (PLEASE FURNISH THE FOLLOWING INFORMATION FOR ALL PRINCIPALS) FULL NAME 1) 2) 3)

    TITLE SOCIAL SECURITY NUMBER HOME ADDRESS % OF OWNERSHIP EXPERIENCE/YRS IN CAR WASH INDUSTRY # OF CAR WASHES CURRENTLY OWNED

    BUSINESS,BANK AND DEBT REFERENCES (INCLUDE OTHER FINANCE COMPANIES WHO FINANCED CURRENT CAR WASHES)

    INSTITUTION ACCOUNT NAME ACCOUNT NUMBER CONTACT PHONE NUMBER

OIL COMPANY REFERENCE (IF APPLICABLE)

    Name: Phone Number:

    Account # Contact:

AUTHORIZATION FOR DISCLOSURE OF CREDIT INFORMATION

    Because I have applied to Petroleum & Franchise Capital (PFC) for financing, I hereby authorize you to disclose to PFC the personal and/or business set forth in attached enclosures. I hereby represent to PFC that such information is true, correct and complete. A photostatted copy of this authorization shall be valid as the original. This authorization will expire ninety (90) days from the date set forth below. If my application for business credit is denied, I have the right to a written statement of the specific reasons for denial. To obtain the statement, I will contact Operations Manager, PFC, 33 Mill Plain Rd., Danbury, CT 06811 or call (203) 778-1000 within 60 days from the date I am notified of your decision. You will send me a written statement of reasons for the denial within 30 days of receiving my request for the statement. Notice: The federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applications on the basis of race, color, religion, national origin, sex, marital status, age, (provided the applicant has the capacity to enter into a 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. The federal agency that administers compliance with the law concerning the creditor is the Federal Trade Commission, Equal Credit Opportunity, Washington, DC 20580. The undersigned agrees that PFC has the right to confirm the accuracy of the above referenced credit information and that PFC has the right to accept or reject this lease application. I irrevocably authorize you to execute and file any UCC financing statement in your name which relates to this transaction.

    SIGNATURE TITLE DATE SIGNATURE TITLE DATE

    SIGNATURE TITLE DATE SIGNATURE TITLE DATE

    CAR WASH INFORMATION (IF MORE THAN THREE LOCATIONS, PLEASE ATTACH SEPARATE SHEET) CAR WASH ADDRESS:

    LEGAL NAME OF ENTITY:

    ATTACHED TO GAS STATION? Yes No Yes No Yes No

YEAR CAR WASH ESTABLISHED:

    DATE ACQUIRED:

PURCHASE PRICE: IF APPLICABLE

    FINANCED BY:

    YEAR LEASE EXPIRES:

LANDLORD NAME & ADDRESS:

    1998 1999 1998 1999 1998 1999 PRETAX INCOME

     MONTHLY DEBT SERVICE

USE OF FINANCE PROCEEDS FOR THIS TRANSACTION (PLEASE PROVIDE EQUIPMENT AND CONSTRUCTION

    QUOTATION)

    NEW CONSTRUCTION RENOVATION If yes, # of Years in Business _________

     ATTACHED TO GAS STATION? NO YES If yes, please provide the monthly gallons sold __________

     Brand________________________

    FOR ADDITIONAL INFORMATION, CONTACT

    Petroleum & Franchise Capital

    33 MILL PLAIN RD., DANBURY, CT 08611

    203-778-1000

    FAX 203-791-8860

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