Lion Tech Finance Application

Taylor Folwell | Lion Technology Finance

3200 N Hayden Rd. #255

Scottsdale, AZ 85251

Email:taylor@liontechfinance.com

Cell: 480-956-3885

Please enable JavaScript in your browser to complete this form.

Full Name *

Phone Number *

Complete Legal Name of Business Including Any Dba's

Company Structure *

Sole Prop
LLC
Non-Profits-Corp.
C-Corp
Partnership

Date of Birth

Email Address *

Date Business Started *

Mailing Address of Business *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Federal Tax ID#

OWNER/ STOCKHOLDER INFORMATION

How Many Owners *

One Owner
Two Owners
Three Owners

Full Name *

Title *

Date of Birth

Home Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

% Ownership *

Social Security

Type of Home

Rent
Own

Full Name *

Title *

Date of Birth

Home Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

% Ownership *

Social Security

Type of Home

Rent
Own

Full Name *

Title *

Date of Birth

Home Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

% Ownership *

Social Security

Type of Home

Rent
Own

Equipment Information

Vendor Name

Phone

Model Year (If Used)

Term Requested

24
36
48
60
Other

Contact

Approximate Cost

Type of Equipment

Age of Equipment

By selecting below, I/we acknowledge and agree to the credit report authorization, UCC filing, Patriot Act Disclosure, and ECOA notice. Terms

Terms *

I agree
I do not agree

Applicant's Signature *

Clear Signature

Print name *

Title *

Date *

Upload 3 Months of Bank Statements (Optional)

Click or drag files to this area to upload. You can upload up to 5 files.