VGM Financial Services - We're more than money HomeAbout VGMFSContact VGMFS
VGM Financial Services - We're more than money
Homecare Credit Application

Business Information Thank you for visiting the VGM Financial Services Online Credit Application. This Internet based application is offered by VGM Financial Services, a division of TCF National Bank (herein referred to as “VGMFS”). By submitting this application (“Application”), you confirm that you have read and agreed to the "Conditions of Use" which regulate the use of this site and the submission of applications via this site. Click for a PDF version of the Homecare Credit Application
*Required field
Legal Name*: Mo.Yr Established:
Street Address*: Yrs Under Current Ownership:
City*: State*: Zip*: Date & State Incorporated:
Email*: Federal ID Number:
Telephone*: Fax: Are You Tax Exempt? Yes    No
Contact Title: Tax ID Number:
Gross Annual Revenue $  
Business Structure*:
 
Partners / Principals Name (Owner/Principal) : % Owned:
Social Security Number:
Date of Birth:
Has the Owner ever declared bankruptcy : Yes    No     When?
Home Street Address:
City: State: Zip: Phone No.:
Name (Owner/Principal) : % Owned:
Social Security Number:
Date of Birth:
Has the Owner ever declared bankruptcy : Yes    No        When?
Home Street Address:
City: State: Zip: Phone No.:
 
References Business Bank Reference Name:
Address:
City: State: Zip:
Contact: Phone No.:
Account Number & Type: Savings   Checking   Loan   Other     Number:
Trade Reference (Name/Phone):
 
Equipment Manufacturer:    Total Equipment Cost:
Equipment Description:
24 Months    36 Months    48 Months    60 Months    72 Months    84 Months
$1.00    FMV    10% P.U.T.   
 
  *Required field

Security Image: This Is CAPTCHA Image

Verify Code:

For security purposes, please enter the code shown in the above image.

 

I agree to the terms and conditions

By submitting this Application, the undersigned warrants that the applicant and each individual listed as a principal, partner, owner, guarantor or obligor consent, authorize and warrant as follows: (a) VGM Financial Services and its agents (“VGMFS”) may obtain commercial and consumer credit reports, investigate references and statements, and make other credit inquiries about the applicant and all such individuals, and anybody contacted in connection therewith may release any credit and financial information; (b) VGMFS and its affiliates may share with one another financial, credit and other information about the applicant and such individuals and use shared information to market to the applicant and the individuals; (c) the information on or accompanying this Application is true and complete, and the undersigned will notify VGMFS of any material change in any information; (d) this Application is submitted in connection with financing solely for business and commercial purposes and NOT for personal, family or household purposes; (e) the applicant, if an individual, is a citizen or lawful permanent resident of the United States; and (f) this Application will apply to any future request for additional financing and all notices, disclosures, consents and warranties shall be deemed repeated for each future request, unless the applicant submits a new written application. VGMFS does not make offers or commitments to extend credit except in final signed documents and, in limited circumstances, in and pursuant to the terms and conditions of written commitment letters. Term sheets, proposal letters, approval letters and the like are not commitment letters.

READ CAREFULLY BEFORE SUBMITTING THIS APPLICATION: We recommend that you print the Application, sign it below and fax or mail it to us at the address set forth above. If you send this Application by unencrypted and non-secure e-mail, the contents including non-public information may be at risk, and we are not responsible for the security of the contents or for any theft or loss of data during e-mail transmission. If you decide to assume the risk of submitting this Application by e-mail, enter your name as authorized agent below. By entering your name and submitting this Application to us, you agree that this Application is an electronic record executed by you using your electronic signature.

IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT. To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account. What this means for you: When you open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver’s license or other identifying documents.

EQUAL CREDIT OPPORTUNITY ACT. If your application for business credit is denied, you have the right to a written statement of the specific reasons for the denial. To obtain the statement, please contact our Customer Service Manager, 11100 Wayzata Blvd., Suite 801, Minnetonka, MN 55305 (866-311-2755) within 60 days from the date you are notified of our decision. We will send you a written statement of reasons for the denial within 30 days of receiving your request for the statement. NOTICE: The federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national origin, sex, marital status, age (provided the applicant has the capacity to enter into a binding contract); because all or part of the applicant’s income derives from any public assistance program; or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act. The federal agency that administers compliance with this law concerning this creditor is the EQUAL CREDIT OPPORTUNITY ACT. If your application for business credit is denied, you have the right to a written statement of the specific reasons for the denial. To obtain the statement, please contact our Customer Service Manager, 11100 Wayzata Blvd., Suite 801, Minnetonka, MN 55305 (866-311-2755) within 60 days from the date you are notified of our decision. We will send you a written statement of reasons for the denial within 30 days of receiving your request for the statement. NOTICE: The federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national origin, sex, marital status, age (provided the applicant has the capacity to enter into a binding contract); because all or part of the applicant’s income derives from any public assistance program; or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act. The federal agency that administers compliance with this law concerning this creditor is the Bureau of Consumer Financial Protection, 1700 G Street NW., Washington DC 20006 and the Federal Trade Commission, Equal Credit Opportunity, Washington, DC 20580.

(Please retain a copy of this notice and application for your records, updated 7/14)

         
Experts at delivering equipment finance solutions

1111 West San Marnan Drive, Suite A2 West, Waterloo, IA 50701-8926 - Phone: 800.532.7392

Home | About | Homecare | Golf | Homecare Application | Golf Application | Careers | Contact | Terms & Conditions | Vendor Services

Site created and powered by VGM Forbin. Copyright 2017 : VGM Financial Services. All Rights Reserved.