Atria Capital Secure Finance Application

 

Your information will be protected because your Internet connection to the website is SSL Secured (128-bit). However, if you would still prefer to fax in your finance application, you may download the fax form.



First Name
Last Name
E-mail
Phone

Company Information

Company Name
Street Address
City
State
Zip
Telephone
Fax
Time in business years
Business Type Sole proprietor
Corporation
Partnership

Principal Owner Information

Principal 1
First Name
Last Name
Social Security #
Address
City
State
Zip
Ownership %
Product
Retail Cost
Lease Term
 
Principal 2
First Name
Last Name
Social Security #
Ownership %

Bank & Trade References

Trade Reference 1
Phone Number
Trade Reference 2
Phone Number
Bank Name
Bank Account #
Bank Phone
   

Vendor Information

Company name
Contact name
Phone number
E-mail address

How did you find Atria Capital?

Delivery of this application bearing a facsimile signature(s) shall have the same force and effect as if the application bore an inked original signature(s). The applicant certifies that all information provided is true, correct and complete and that the account will be used solely for business or commercial purposes. The applicant, owner(s) and guarantor (if any) authorize Atria Capital Corporation or its designee(s) or assignee(s) to obtain any information it may request from any business or consumer reporting agency(ies) or other sources that provide credit reports, account history information, credit and employment history or similar information; such authorization shall extend to update renewal of credit and for reviewing or collecting the account. The applicant acknowledges that, based upon such information and other factors which may apply, Atria Capital or its assignee(s) or designee(s), in their sole discretion, may either grant or decline to grant credit.

By submitting this application, I also wish to continue to receive updates from Atria Capital Corp. regarding our account. Information should be sent to the fax and/or email address given for the account.