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- 1. U.S. BANCORP EQUIPMENT FINANCE SMALL BUSINESS GROUP Application Business Information Are you a U.S. Bancorp Customer? Check all that apply. Personal Checking Business Checking Business Loans Other ______________________________________________________________________________________________________ Business Legal Name Federal Tax ID Entity (Sole prop, partnership, LLC, etc.) ______________________________________________________________________________________________________ DBA (if any) Primary Contact Title ______________________________________________________________________________________________________ Business Phone Cell Phone Home Phone Fax E-Mail Address ______________________________________________________________________________________________________ Business Street Address City, State Zip Business Mailing Address City, State Zip ______________________________________________________________________________________________________ Date Business Started Years Under Current Ownership Nature of Business ______________________________________________________________________________________________________ Primary Bank Phone # Checking Account # ______________________________________________________________________________________________________ Other Business Loan/Lease (company) Account # Phone # Contact Name ______________________________________________________________________________________________________ Insurance Agent Phone # Equipment Information ______________________________________________________________________________________________________ Equipment Description Estimate Equipment Cost Expected Delivery Date Equipment Type (New or Used) ______________________________________________________________________________________________________ Vendor Name Vendor Contact Vendor Phone # Vendor Address ______________________________________________________________________________________________________ Equipment Location Principal Information ______________________________________________________________________________________________________ Principal Name (1) Principal Title Home Address City, State Zip Date of Birth ______________________________________________________________________________________________________ Phone # Percent of Ownership Social Security # Signature ______________________________________________________________________________________________________ Principal Name (2) Principal Title Home Address City, State Zip Date of Birth ______________________________________________________________________________________________________ Phone # Percent of Ownership Social Security # Signature For Office Use Only ______________________________________________________________________________________________________ Dennis Singleton dlsing1 801-440-0093 3894 Banker Preferred ID Phone Branch # Each individual signing as principal certifies that the information provided is accurate and complete. Each individual signing as principal authorizes lender or any other lending sources to obtain a consumer credit report that will be ongoing and relate not only to the evaluation and/or extension of the business credit requested, but also for purposes of reviewing the account, increasing credit line, taking collection action on the account and for any other legitimate purpose associated with the account as needed. Customer(s) further authorizes banks, trade references, and financial institutions the right to release information to us. IMPORTANT NEW CUSTOMER INFORMATION: to help the government fight the funding of terrorism and money laundering activities, Federal law requires financial institutions to obtain, verify and record identifying information on new customers. The personal data requested above will allow us to identify each person signing this application. We may also ask for copies of drivers’ licenses or other identifying documents. By providing us with a telephone number for a cellular phone or other wireless device, you are expressly consenting to receiving communications at that number – including but not limited to prerecorded or artificial voice message calls, text messages, and calls made by an automatic telephone dialing system – from U.S. Bancorp and its affiliates and agents. This express consent applies to each such telephone number that you provide to us now or in the future and permits such calls regardless of their purpose. ECOA Notice (to be retained by applicant(s) Thank you for your business credit application. We will review it carefully and get back to you promptly. If your application for business credit is denied, you have the right to a written statement of the specific reasons for that denial. To obtain that statement, please write to us at: 2 Meridian Crossing, Richfield, MN 55423 within 60 days from the date that you were notified of our decision. We will send you a written statement of the reasons for the denial within 30 days of your request for the statement. NOTICE: The Federal Equal Credit Opportunity Act prohibits creditors from discriminating on the basis of race, color, religion, national origin, sex, marital status, age (provided the applicant has the capacity to enter 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. The federal agency that administers our compliance with this law is the OCC Customer Assistance Group, 1301 McKinney St. Ste. 3450, Houston, TX 77010-9050. Please fax completed application to 801-593-9654