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Please complete the form below in its entirety and submit to our office for our review. We will process it and review it immediately upon receipt. Please allow a few days for the review process. Thank your loan request.

                                             THE COMPANY:

Company Name:

 

Referred By:

 

Gulfstream Finance Representative:

 

Company Address:

 

City:

 

State:

 

Zip:

 

Company Telephone:

 

Company Fax:

 

Gross Income Two Years Ago:

 

Gross Income Last Year:

 

Year-To-Date Gross Income

 

Gross Profit To-Date:

 

Last Year Gross Profit:

 

THE LOAN:

Loan Description:

 

If Equipment, Describe:

 

Present Value:

 

Sales Price:

 

Loan Amount:

 

Down Payment:

 

Years on Loan

 

Existing Lien:

 

Balance Remaining:

THE BORROWER: 

Borrower Name:

 

Title:

 

Home Address

 

City:

 

State:

 

Zip:

 

Social Security:

 

Monthly Gross Income:

 

Monthly Expenses:

 

Net Worth:

 

Home Telephone:

 

Cellular Phone:

 

THE CO-BORROWER:

Co-Borrower Name:

 

Co-Borrower Title:

 

Home Address:

 

City:

 

State:

 

Zip

 

Social Security:

 

Monthly Gross Income:

 

Monthly Expenses:

 

Net Worth:

 

Home Telephone:

 

Cellular Phone:

 

EMAIL CONTACT:

Email:
 
 
 

 

I hereby authorize the Gulfstream Finance Corporation to verify my past and present employment earnings records, bank accounts, stock holdings, and any other asset balances that are needed to process my loan application. I further authorize Gulfstream Finance Corporation to order a consumer credit report and verify other credit information, including past and present mortgage and landlord references. It is understood that an Email submission and/or copy of this form will also serve as authorization. The information the obtained in this application is only to be used in the processing of my application for a loan.

 

Privacy Act Notice:This information is to be used by the agency collecting it or its assignees in determining whether you qualify as a prospective borrower under its program. It will not be disclosed outside the agency except as required and permitted by law. You do not have to provide this information, but if you do not your application for approval as a prospective borrower may be delayed or rejected.

   

 

  

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