DADE CAPITAL CORP.

On-Line Application


This is the fastest way to get your vehicle or equipment funding approved! Just fill in the information on this form on-line and a representative will contact you. This form is secure, so your information will not be compromised.

To use the on-line application, you must use a browser with online form features. If you don't see a place on this form for you to type in your information, you cannot use this form.

If you'd rather enter this information off-line, feel free to click here to print it, fill it out, and fax it to 419-931-9001 or call one of our representatives at (800) 823-9688.

Important Information about Procedures for Opening a New Account or Obtaining Credit

To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account or obtains a lease or loan.

What this means for you: When you apply, we will ask for your name, address, date of birth and other information that will allow us to identify you. We may also ask to see your driver's license or other identifying documents.

 

Billing Information
Company Name
Contact Name
Title
Street Address
City
State
Zip
Telephone
Fax
Toll-free
Mobile
E-mail Address
Lessee Information
Nature of the Business
Type of Business
Number of Years in Business
Personal Information on Officers, Partners, or Guarantors
Contact Person
Title
Social Security No.
 
Home Address
City
State
Zip
Telephone
Mobile

Contact Person
Title
Social Security No.
 
Home Address
City
State
Zip
Telephone
Mobile

Contact Person
Title
Social Security No.
 
Home Address
City
State
Zip
Telephone
Mobile
Company Bank References (Must have a 2 year history)
Name of Bank
Branch
Contact Officer
Telephone Number
Checking Account Number
Date Account Opened
Loan Account Number
Date Account Opened

Name of Bank
Branch
Contact Officer
Telephone Number
Checking Account Number
Date Account Opened
Loan Account Number
Date Account Opened
Trade References and Other Leases (Must have a 2 year history)
Company Name
City/State
Contact Person
Telephone Number

Company Name
City/State
Contact Person
Telephone Number

Company Name
City/State
Contact Person
Telephone Number

Equipment/Vehicle Description
Type of Equipment
Estimated Cost
Vendor/Company Name
Contact Person
Telephone Number
Acknowledgements & Authorizations
By clicking on the submit button below, you, the credit applicant, certifies that the information given for credit purposes is true and correct; authorizes, its assigns, and any credit bureau or other investigative agency to investigate the references, statements and other information accompanying this application; and, expressely authorizes that bank and trade references listed herein to release credit and information requested as part of said investigation.
ECOA Notice:  If your application for business credit is denied, you have the right to a written statement of the specific reasons for the denial. To obtain the statement, please contact Credit Disclosure Administrator, FIRSTCORP, 7145 SW Varns St., Portland, OR 97223, within 60 days from the date you are 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. The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis 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 from any public assistance program; or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act. The federal agency that administers compliance with this law concerning this credit is the Federal Trade Comission, Equal Credit Opportunity, Washington, DC 20580.