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Para preguntas sobre el financiamiento llame a Jayson Miranda 602.783.8366

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Business Information
Business Name ::
DBA Name ::
Business Type ::
Time In Business :: Years Months
Business Credit ::
Business Address ::
City ::
State ::
Zip Code ::
Business Phone #
- - - Optional Info - - -
Fax #
Federal Tax Id # (EIN)
Website ::
Comments ::
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Equipment Information
Equipment Cost $ New Used
Ship To Address ::
Same as Business Address
Other Address
Equipment Location ::
Same as Ship To Address
Other Address
Equipment Description...
Owner 1 Information
First Name ::  Last Name ::  
Title ::  Ownership %
Social Security # 
Address :: 
City, State, Zip :: 
Mobile Phone # 
Home Phone # 
Email :: 
Add a 2nd Owner or Principal to this Application? Yes No
Click Here to accept the Terms & Conditions of this Application (below)
Terms & Conditions single page view
You authorize TimePayment Corp., its authorized affiliates, outside attorneys and authorized suppliers to check your credit and employment history for the purposes of determining your credit worthiness at the time of application or thereafter in connection with the same transaction or extension of credit and for the further purposes of reviewing the account, taking collection activity on the account, and skip tracing. You further authorize TimePayment Corp. to provide history information to others about your credit standing and your credit experience, including but not limited to credit bureaus, other companies, outside collection agencies and outside attorneys.

You understand that you are providing written instructions to TimePayment Corp. under the Fair Credit Reporting Act authorizing TimePayment Corp. to obtain information from your personal credit report or other information from credit bureaus. You authorize TimePayment Corp. to obtain such information solely to conduct a pre-qualification for credit.

All information submitted as part of your application for credit, together with any accompanying financial statements, schedules, or other materials, is submitted for the purpose of credit qualification and is warranted to be true, correct, and complete.

If applying for business credit, you acknowledge and affirm that one or more applicants identified is/are the business owner(s) and is/are personally liable for the business.

You also warrant that by submitting this application for credit, any individual identified above who is either a principal, a personal guarantor or cosigner, or a sole proprietor of the credit applicant, recognizing that his or her individual credit history may be a factor in the evaluation of the application for credit, is authorizing inquiry into their credit worthiness, including but not limited to obtaining a consumer credit report, and shall hold TimePayment Corp., it assignees, agents, or nominees harmless from same.

You understand that such investigation may include seeking information as to the background, credit, and financial responsibility of your business, its officers, principals, any personal guarantors or cosigners, and any corporate guarantors if applicable.

The Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religions, national origin, sex, marital status, or 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 in good faith exercised any right under the Consumer Credit Protection Act. The federal agency administering compliance with this law is the Federal Trade Commission, Equal Credit Opportunity, Washington, D.C. 20580.

If for any reason your application for credit is denied, you have the right to a written statement of the specific reasons for the denial. To obtain the statements, pleased write to us at the following address within 60 days from the date you are notified of our decision, and we will send you a written statement of the reasons for the denial of credit within 30 days of receiving your request for the statement.

TimePayment Corp.
200 Summit Drive Suite 100
Burlington, MA 01803

If you received a separate decline notice from one of our underwriters, please contact them directly for the specific information.

You are consenting to receive communications from us and from or on behalf of our underwriters either via phone (including voice and text messages), in writing through postal mail, or via email. You consent that such communications may be generated by automatic dialer systems, pre-recorded voice messages, and automatically generated text messages or emails. For any calls or text messages, your cellular or mobile telephone provider may charge you according to the type of plan you carry and you are responsible for such charges.

You also agree we may contact you at any email address(es) you have provided or may provide in the future or any phone number(s) you have provided or may provide in the future. You agree that we may record any phone calls between you and us for quality control purposes or our own legal protection. You agree that any such communication is not unsolicited for purposes of federal or state law. If you authorize a third party to communicate on your behalf with us, our agents, or our underwriters regarding your account with us, you agree and acknowledge that we may disclose information about your account to the third party.

You agree to conduct transactions via electronic means.


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