Veterinary Equipment Financing

veterinary equipment financing banner form left 960x215

 

    Primary Information

    First Name (required)

    Last Name (required)

    Suffix/Degree

    Your Email (required)

    Home Phone (required)

    Cell Phone (required)

    Fax (required if applicable)

    When Is the Best Time To Contact You?

    Marital Status (required)

    Professional License Number and State (required)

    Year Graduated (required)

    Years in Practice (If Applicable)

    Years of Management Experience (If Applicable)

    Home Street (required)

    City (required)

    State (required)

    Zip (required)

    Professional Information

    Practice Name (If Applicable)

    Practice Phone (If Applicable)

    Practice Fax (If Applicable)

    Practice Address (If Applicable)

    City (If Applicable)

    State (If Applicable)

    Zip (If Applicable)

    Professional Specialty

    Business Structure

    Years in Business (If Applicable)

    Annual Revenue (If Applicable)

    Loan Information

    Desired Financing Start Date (required)

    Loan Amount (required)

    Loan Type (required)

    Do You Currently Have Equipment In Mind To Purchase? (required)

    YesNo

    Please Briefly Tell Us What Equipment You Wish to Purchase ? (required)

    Please Describe Your Role (required)

    OwnerBorrower

    Have You Ever Filed For Bankruptcy? (required)

    YesNo

    Do You Have Any Legal Actions Against You? (required)

    YesNo

    Do You Have Any Outstanding Tax Liens? (required)

    YesNo

    Are You Currently Involved In Any Other Business Or Venture? (required)

    YesNo

    Average Monthly Credit Card Sales/Processing (If Applicable)

    What Is Your Personal Credit Score? (required)

    Have You Had Any One-Time Personal or Family Life Events or Hardships That May Have Affected Your Credit Rating In the Last 7 Years? (If Applicable)

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