Online Application

Step 1: Business Information

Company *

First Name *

Last Name *

Address

Business Address *

City

State

Country

Postal code

Email *

Phone *

Type of Business *

Years Under Current Ownership *

Federal Tax ID Number *

Name of Financial Representative *

Equipment Information

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Equipment Cost *

Equipment Description *

Desired Term *

End of Term Option *

Principal Ownership

Principal First Name *

Principal Last Name *

Percent Ownership *

Social Security Number *

Professional License *

Home Phone *

Home Address *

Principal 2

Percent Ownership 2

Social Security Number 2

Professional License 2

Home Phone 2

Home Address 2

Principal 3

Percent Ownership 3

Social Security Number 3

Professional License 3

Home Phone 3

Home Address 3

Bank Reference

Bank Name *

Business Checking Account Number *

Bank Phone *

Bank Reference Contact F.N *

Bank Reference Contact L.N *

Trade Reference

Trade Contact Phone *

Trade Company *

Trade Contact Name *

SMS Privacy Policy

By submitting your phone number, you consent to receive text messages (SMS) from Western Mixer. You can opt-out at any time by replying with "STOP." Standard message and data rates may apply. Message frequency may vary. For further assistance, reply with "HELP" or call 303-426-0006.

Additional Information

Additional information may be required based on the duration of business operations, current credit status, and the requested application amount. By signing below, each individual certifies that the information provided in this credit application is accurate and complete. Each individual further authorizes you, or any lender or funding source involved (collectively referred to as "Lenders"), to obtain information from the references listed above and to request a consumer credit report. This report will be ongoing and used not only for the evaluation and/or extension of the business credit requested but also for reviewing the account, increasing the credit line (if applicable), taking collection actions, and for any other legitimate purpose related to the account as needed. Each individual signing below also waives any right or claim they may have under the Fair Credit Reporting Act, in the absence of this continuing consent.

I agree to terms & conditions provided by the company. By providing my phone number, I agree to receive text messages from the business.