Guarantor

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Equipment

Brief Description of Equipment

Condition of Equipment New Used New & Used

Equipment Cost

Seller Name

Contact Name

Contact Phone

Are you considering the purchase of other equipment? Yes No

The applicant 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 applicant authorizes PFS, and/or its assigns, to obtain the credit history of the undersigned and the officers/principals of the company and to investigate (directly or indirectly) such credit history from any source. The applicant further authorizes PFS and/or its assigns, now and in the future, to notify, communicate, market to, follow up or inquire with this company by email, phone, SMS and/or facsimile.