Makino

CREDIT APPLICATION


		English (USA) Credit Application Amount Requested $ Equipment


CUSTOMER INFORMATION

*Legal Business Name		* Phone	Fax
DBA (if applicable)	Street	City	State	Zip
* Contact Name	*Contact E-mail	Date Business Started	Current Ownership Since

Fed Tax ID#	Company Website
Business Type


OWNERSHIP INFORMATION

Name		Title	% Ownership	Home Phone No.
Home Address / City / State / Zip
Name		Title	% Ownership	Home Phone No.
Home Address / City / State / Zip

REFERENCE INFORMATION

Bank #1 Name	Account No.	Contact	Phone No.	Fax No.
Equipment Finance Reference	Account No.	Contact	Phone No.	Fax No.

Equipment Finance Reference	Account No.	Contact	Phone No.	Fax No.

Trade #2 Reference	Account No.	Contact	Phone No.	Fax No.
Trade #3 Reference	Account No.	Contact	Phone No.	Fax No.

EQUIPMENT INFORMATION

Equipment Location (if same as business address listed above, type "same as above" in the space below.				County
Equipment Quantity	Equipment Model	Equipment Serial No.	Delivery Date	Equipment Status
				NewUsed
Please Describe If This Equipment Is For Expansion Or To Replace Existing Equipment & Intended Uses:

FINANCE STRUCTURE

Equipment Cost			Contract Term
Down Payment / Trade In			Advance Rental Payments
Finance Amount			Structure

Special Considerations

YesNoAPPLICANT HEREBY AUTHORIZES MAKINO, INC. AND ITS AGENTS (1) TO OBTAIN MORE CREDIT INFORMATION ABOUT THE COMPANY AND ITS PRINCIPLES AND TO MAKE INQUIRIES IN CONNECTION WITH THIS APPLICATION; (2) TO SHARE CREDIT INFORMATION WITH MAKINO AFFILIATES AND AGENTS AS WELL AS, APPLICANTS OTHER CREDITORS, BUREAUS AND PERSONS WHO HAVE OR EXPECT TO HAVE FINANCIAL DEALINGS WITH THE APPLICANT OR ITS PRINCIPALS NAMED ABOVE; (3) TO SHARE COLLECTION OF INFORMATION WITH APPLICANTS AND OTHER CREDITORS. ALL THE INFORMATION IN THIS APPLICATION IS TRUE, COMPLETE AND CORRECT. THE PERSONS WHO CHECKED "YES" ON BEHALF OF APPLICANT ARE AUTHORIZED TO MAKE THIS APPLICATION ON ITS BEHALF AND AGREE TO THE FOREGOING.