Please Complete This Application as Fully as Possible

Business Marine Application

- Step 1 of 4

Business Name *

Business Structure *

• Corporation
• Partnership
• LLC
• LLP
• Sole Prop
• Cooperative

State of Incorporation-Select-AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon

Business Address

City

State-Select-AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon

Zip Code

Business Phone

Annual Revenue

Date business started

Years in business under current ownership

Federal Tax ID

Contact Name

First

Last

Contact Cell Phone

Contact Email

Email

Confirm Email

Next

Owner(s)

Principal Owner # 1

Principal Owner #1 Name *

First

Last

% Ownership

Social Security Number *

Principal #1 Home Address

City

State- Select-AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and Labrador.Northwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon

Zip Code

Principal #1 Phone

Principal #1 Cell Phone

Principal #1 Driver’s license number

Drivers License State-Select-AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon

Date Of Birth

Email

Email

Confirm Email

Next

Dealer, Seller, or Builder Information

Dealer / Builder Name

If no dealer, enter NONE.

Dealer Address

Dealer City

Dealer State-Select-AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon

Delaer Zip Code

Dealer Contact

First

Last

Dealer Contact Phone

Dealer Contact Cell Phone

Dealer Email

Email

Confirm Email

Next

Vessel Description

Builder / Manufacturer

Type of VesselTugBargeCrew BoatSupply BoatTanker BoatFishing VesselPatrol - Security VesselsPassenger VesselsCargo VesselsOther

Year, Model and LOA

Engine(s) Manufacturer and Horsepower

Number of Engines

• Single
• Twin
• Triple
• Quad

Fuel

• Gas
• Diesel

Boating Experience (Please describe other boats owned)

Total Cost

Preferred Finance Structure

• Capital Lease
• Operating Lease
• EFA (Equipment Finance Agreement)
• Other (Please Specify Below)

Other Desired Finance Structure

Term Requested-Select-3 yr5 yr7 yr10 yr15 yr20 yr25 yr

Choose Term from dropdown

Notes

I (we) authorize WorkBoat Capital, its Assigns, and/or their Lenders to obtain information in connection with this application, including credit inquiries/reports, employment history and any other information necessary to evaluate credit. Upon request, I (we) will be informed as to whether or not a credit report was requested by WorkBoat Capital in conjunction with this application and if a report was requested. I (we) will be informed the name and the address of the consumer reporting agency that furnished the report. Furthermore, this application shall remain the property of WorkBoat Capital.

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