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Gehl Finance Application

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Fax completed application to: (877) 408-4636

For questions please call: (800) 266-3255

BUSINESS EQUIPMENT FINANCE APPLICATION


CUSTOMER (EXACT LEGAL NAME) DBA

STREET ADDRESS (NO P.O. BOXES) CITY STATE ZIP FEDERAL TAX ID NO. (IF ANY)

PHONE NO. CELL NO. FAX NO.

BUSINESS DESCRIPTION YEARS IN BUSINESS YEARS UNDER CURRENT OWNERSHIP GROSS ANNUAL SALES
$
STATE & DATE OF INCORPORATION SALES TAX EXEMPT:
CORPORATION PARTNERSHIP SOLE PROPRIETOR LLC Yes (Attach copy of certificate)

OWNERSHIP INFORMATION
OWNER / PARTNER / MEMBER TITLE SOCIAL SECURITY NO. % OWNED DATE OF BIRTH

STREET ADDRESS CITY STATE ZIP HOME PHONE NO.

OWNER / PARTNER / MEMBER TITLE SOCIAL SECURITY NO. % OWNED DATE OF BIRTH

STREET ADDRESS CITY STATE ZIP HOME PHONE NO.

NOTE: If additional partners/shareholders/members please include like information on second page.


BANK AND SECURED L OAN OR LEASE REFERENCES
BANK NAME CONTACT PHONE NO. ACCOUNT NO.

BANK / FINANCE COMPANY CONTACT PHONE NO. ACCOUNT NO.

BANK / FINANCE COMPANY CONTACT PHONE NO. ACCOUNT NO.

EQUIPMENT DESCRIPTION / TERMS OF SALE / DEALER INFORMATIO N


EQUIPMENT DESCRIPTION

EQUIPMENT DESIGNATION CONTRACT TYPE IF LEASE, END-OF-TERM OPTION TERM SKIPS


NEW USED LEASE LOAN
DEALER NAME CONTACT TELEPHONE NO.

SALES PRICE: $ ECOA NOTICE: DISCLOSURE OF RIGHT TO REQUEST SPECIFIC REASONS FOR CREDIT DENIAL
GIVEN AT TIME OF APPLICATION (BUSINESS CREDIT). If your application for business credit is
FREIGHT/DELIVERY: $ denied, you have the right to a written statement of the specific reasons for denial. To obtain
SALES TAX: $ the statement, please contact Credit Manager, Manitou Finance, 475 Sansome Street, 19th
Floor, San Francisco, California 94111, (415) 956-5174 within 60 days from the date you are
NET TRADE-IN: $ notified of our decision. We will send you a written statement of reasons for the denial within
30 days of receiving your request for the statement. Notice: The federal Equal Credit
DOWN PAYMENT: $
Opportunity Act prohibits creditors from discriminating against credit applicants on the basis
RENTAL CREDIT: $ of race, color, religion, national origin, sex, marital status, age (provided the applicant has the
capacity to enter into a binding contract); because all or part of the applicant’s income derives
DOC FEE: $ from any public assistance program; or because the applicant has in good faith exercised any
INSURANCE: $ right under the Consumer Credit Protection Act. The federal agency that administers
compliance with this law concerning the creditor is the Federal Deposit Insurance Corporation
TOTAL TO FINANCE: $ Consumer Response Center, 2345 Grand Boulevard, Suite 100, Kansas City, MO 64108.

I understand this equipment application may be approved based on my business and personal credit. I authorize Manitou Finance, Manitou Americas, Inc., or any other
lender to which this application is submitted, and their respective affiliates and assignees, to check references, bank accounts and credit information for use in connection
with this credit transaction. I further authorize the release of this application to any other lender. NOTE: Financial Statements or tax returns may be required.

X
AUTHORIZED SIGNATURE DATE

X
AUTHORIZED SIGNATURE DATE

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