of Applicant Business - IBM

IBM Global Financing offerings are provided through IBM Credit LLC in the US, IBM Canada Ltd. and other IBM subsidiaries or divisions worldwide. 1...

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Please print or type legibly. AN INCOMPLETE FORM WILL DELAY PROCESSING. ATTACH A COPY OF ORGANIZATIONAL DOCUMENTS (e.g. Articles of Incorporation, Articles of Organization, etc.)

1. LEGAL NAME of Applicant Business: Use exact legal name in articles of incorporation/organization; partnerships use exact legal name in partnership agreement Other name(s) business is known as:

Main Business Telephone No.:

FAX No.:

Business is a (mark one): ( ) Corporation

( ) Partnership

( ) Limited Liability

( ) Proprietorship

( ) Sub Chapter “S”

( ) Business Trust

( ) Other ____________________

Date Started or Acquired: ____________________ Organization No. (Assigned by State of Organization):_______________ State of Organization/Incorporation: ____________ Website Name: __________________________________________ Amount of Credit Line Requested: ____________________ Projected Total Financing Volume: _________________________

2. Principal/Other Locations: (List all other locations including sales offices/warehouses/foreign locations) Street Address/City/ State/Zip

Inventory Location?

Own/ Rent

Principal/HQ Secondary (If more than two, attach a list of additional locations)

Attach a listing of landlord name, address and telephone number for all business locations in the following states: AL, AZ, DC, DE, FL, GA, IA, KY, LA, MD, MS, NC, NJ, NM, OR, PA, SC, TX, VA, WA, WV

Who are your current A/P and Purchasing contacts? _____________________________________________________________ Who is authorized under your organizational documents to execute loan agreements and grant liens? (Attach evidence of such authorization.) __________________________________________________________________________________________________ ____________________________________________________________________________________________________________________________________________

3. AFFILIATES / SUBSIDIARIES: List all affiliates/subsidiaries, including those outside of the U.S.* Name

Street Address/City/ State/Zip

Nature of Business

% Owned

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* If there are more than two, attach an explanation of the corporate structure. The undersigned hereby warrants and represents that all of the information provided herein, including information provided in any Attachment attached hereto, is true and correct in every aspect. The undersigned further hereby warrants and represents that the attached financial statements accurately represent in every respect, the true and correct financial condition of the business entity that is the subject of this application. The undersigned agrees that if IBM Credit LLC determines that any of the information is false or misleading, this will constitute reasonable and valid grounds for revoking all present and future financing and declaring all sums outstanding immediately due and payable. The undersigned hereby authorizes IBM Credit LLC to gather and use, from time to time, without the undersigned’s knowledge, any and all financial and/or credit information relating to the business entity that is the subject of this application that can be obtained from any source whatsoever including, but not limited to, banks, trade associates and creditors. The undersigned also hereby authorizes IBM Credit LLC to investigate the personal credit history of the undersigned and obtain credit bureau reports on the undersigned from time to time at IBM Credit LLC’s sole discretion.

Signature: __________________________________________________

Date:______________________

IBM Global Financing Commercial Financing Application IBM Global Financing offerings are provided through IBM Credit LLC in the US, IBM Canada Ltd. and other IBM subsidiaries or divisions worldwide.

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IBM Global Financing 6303 Barfield Road, Atlanta, GA 30328 (800) 678 6900

Business Type (from Page 1): ______________; Federal Tax I.D.: _________________ SECTION A. CORPORATIONS ONLY – COMPLETE THIS SECTION. [ ] One officer only; or list officers below.

Name President Vice President Treasurer Secretary Other

SECTION B. Principals* (including Stockholders/Members/Partners). For Sole Proprietors, list owner and spouse as first and second principal and list bank account in the joint owner line. Principal #1

Principal #2

Principal #3

Principal #4

Name Managing Member/General Partner (Yes/No/N.A.) % Owned Social Security # Home Address City, State & Zip Code Home Telephone Joint Owners and Spouses with SSNs * List only those principals who own ten percent (10%) or more of the outstanding shares. If more than four principals, please provide additional names, information, and signatures. Each stockholder who owns 10% or more of the outstanding shares of the business authorizes IBM Credit LLC, by signing below, to investigate its personal credit history and obtain credit bureau reports from time to time at IBM Credit LLC’s sole discretion. Principal Signature: _________________________________________________________________________________________ Principal Signature: _________________________________________________________________________________________ Principal Signature: _________________________________________________________________________________________ Principal Signature: _________________________________________________________________________________________ IBM Global Financing Commercial Financing Application IBM Global Financing offerings are provided through IBM Credit LLC in the US, IBM Canada Ltd. and other IBM subsidiaries or divisions worldwide.

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