Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. - Step 1 of 5Business Name *Business StructureCorporationPartnershipLLCLLPSole PropCooperativeState of Incorporation-Select-AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingBusiness AddressCityState-Select-AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingZipBusiness PhoneAnnual RevenueDate business startedFederal Tax IDContact NameFirstLastContact Cell PhoneContact EmailEmailConfirm EmailNextOwner(s)Principal Owner # 1Principal #1 NameFirstLast% OwnershipSocial Security NumberDate Of BirthPrincipal #1 Home AddressCityState- Select-AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingZip CodePrincipal #1 PhonePrincipal #1 Cell PhonePrincipal #1 Driver’s license numberDrivers License State-Select-AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingEmailEmailConfirm EmailNextPrincipal Owner # 2Principal #2 NameFirstLast% OwnershipSocial Security NumberDate of BirthPrincipal #2 Home AddressCityState-Select-AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingZip CodePrincipal #2 PhonePrincipal #2 Cell PhoneDriver’s license numberDrivers License StateEmailEmailConfirm EmailNextDealer / Seller InformationDealer / Seller NameIf no dealer, enter NONE.Dealer AddressDealer CityDealer State-Select-AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingDelaer Zip CodeDealer ContactFirstLastDealer Contact PhoneDealer Contact Cell PhoneDealer EmailEmailConfirm EmailNextVessel DescriptionBuilder / ManufacturerType of VesselPontoon BoatTour BoatTow / Tug BoatBargeCrew BoatSupply BoatTanker BoatFishing VesselPatrol - Security VesselsPassenger VesselsCargo VesselsOtherYear, Model and LOAEngine(s) Manufacturer and HorsepowerNumber of EnginesSingleTwinTripleQuadFuelGasDieselElectricBoating Experience (Please describe other boats owned)Total CostPreferred Finance StructureCapital LeaseOperating LeaseEFA (Equipment Finance Agreement)Other (Please Specify Below)Other Desired Finance StructureTerm Requested-Select-2 yr3 yr4 yr5 yr6 yr7 yr10 yrChoose Term from dropdownNotesCERTIFICATION AND CREDIT RELEASE AUTHORIZATION I hereby certify that the information contained in this credit application is true and accurate and I hereby authorize our banks and financial institutions to release credit information to Workboat Capital, Inc. In states where permissible, I hereby authorize the filing and recording of UCC financing statements showing Workboat Capital, Inc.'s interest in all the business assets and grant Workboat Capital, Inc. the right to execute them in our company name. I hereby authorize WorkBoat Capital, Inc. and its affiliates, successors and/or designees (and any assignee or potential assignee thereof) and any lending source to whom this application is submitted to obtain consumer credit reports relating to individual credit history and/or creditworthiness. Such authorization shall extend to obtaining a credit profile in considering this application and subsequently for the purposes of update, renewal or extension of such credit or additional credit and for reviewing or collecting the resulting account. By signature below, I/we affirm my/our identity as the respective individual(s) identified in this application. Signature Clear Signature CommentSubmit
CERTIFICATION AND CREDIT RELEASE AUTHORIZATION I hereby certify that the information contained in this credit application is true and accurate and I hereby authorize our banks and financial institutions to release credit information to Workboat Capital, Inc. In states where permissible, I hereby authorize the filing and recording of UCC financing statements showing Workboat Capital, Inc.'s interest in all the business assets and grant Workboat Capital, Inc. the right to execute them in our company name. I hereby authorize WorkBoat Capital, Inc. and its affiliates, successors and/or designees (and any assignee or potential assignee thereof) and any lending source to whom this application is submitted to obtain consumer credit reports relating to individual credit history and/or creditworthiness. Such authorization shall extend to obtaining a credit profile in considering this application and subsequently for the purposes of update, renewal or extension of such credit or additional credit and for reviewing or collecting the resulting account. By signature below, I/we affirm my/our identity as the respective individual(s) identified in this application.