"Automotive Tool & Equipment Expo" - Commercial Financing - Application

<BODY TEXT="#000000" LINK="#0000FF" ALINK="#FF0000" VLINK="#FF0000" BGCOLOR="#FFFFFF" LEFTMARGIN="0" RIGHTMARGIN="0" > <TABLE WIDTH=500 BORDER=0> <TR VALIGN=top> <TD> <form action="finance-app.php" method="post"> <FONT FACE="Arial" SIZE="1"> <TABLE BORDER="0" CELLPADDING="0" CELLSPACING="5"> <TR> <TD> <CENTER> <FONT SIZE="3"> <A HREF="http://automotivetools.com" TARGET="_top"><IMG SRC="../images/automotivetools-logo.gif" WIDTH="250" HEIGHT="62" ALT="Automotive Tools . Com" BORDER="0"></A><BR> <FONT FACE="Arial" SIZE="1"> 51927 Filomena Dr. Shelby Twp., MI 48315<BR> (888)966-3976   (586)566-6180   Fax: (586)566-7415<BR> </FONT> </CENTER> <IMG SRC="../images/sm-spacer.gif" HEIGHT="10" WIDTH="2"><BR> </TD> </TR> <TR> <TD> <U><FONT FACE="Arial" SIZE="2">Personal Information</FONT></U> </TD> </TR> <TR> <TD> <FONT FACE="Arial" SIZE="1"> Name:     <INPUT NAME="P-Name" TYPE="text" SIZE="25">     Email:   <INPUT NAME="Email" TYPE="text" SIZE="25"><BR> Address:  <INPUT NAME="P-Address" TYPE="text" SIZE="60"><BR> City:        <INPUT NAME="P-City" TYPE="text" SIZE="20">       State:   <INPUT NAME="P-State" TYPE="text" SIZE="4">         Zip Code:   <INPUT NAME="P-Zip" TYPE="text" SIZE="12"><BR> Phone :   <INPUT NAME="P-Phone" TYPE="text" SIZE="20">      Social Security #:      <INPUT NAME="SS" TYPE="text" SIZE="21"><BR> </FONT> </TD> </TR> <TR> <TD> <U><FONT FACE="Arial" SIZE="2">Business Information</FONT></U><BR> </TD> </TR> <TR> <TD> <FONT FACE="Arial" SIZE="1"> Name:     <INPUT NAME="Company" TYPE="text" SIZE="25">     Type of Business:   <INPUT NAME="Description" TYPE="text" SIZE="18"><BR> Address:  <INPUT NAME="B-Address" TYPE="text" SIZE="60"><BR> City:        <INPUT NAME="B-City" TYPE="text" SIZE="20">       State:   <INPUT NAME="B-State" TYPE="text" SIZE="4">         Zip Code:   <INPUT NAME="B-Zip" TYPE="text" SIZE="12"><BR> Phone :   <INPUT NAME="B-Phone" TYPE="text" SIZE="14">   Tax ID #:  <INPUT NAME="tax" TYPE="text" SIZE="18">   In Bus. Since:   <INPUT NAME="since" TYPE="text" SIZE="4"><BR> </FONT> </TD> </TR> <TR> <TD><U><FONT FACE="Arial" SIZE="2">Bank Reference</FONT></U><BR></TD> </TR> <TR> <TD> <FONT FACE="Arial" SIZE="1"> Bank name:   <INPUT NAME="bank" TYPE="text" SIZE="57"><BR> Account No.   <INPUT NAME="account" TYPE="text" SIZE="25"><BR> Contact:         <INPUT NAME="bank-contact" TYPE="text" SIZE="15">       Phone number:   <INPUT NAME="bank-phone" TYPE="text" SIZE="25"><BR> </FONT> </TD> </TR> <TR> <TD><U><FONT FACE="Arial" SIZE="2">Trade References</FONT></U> <FONT FACE="Arial" SIZE="1">(Businesses that extend you monthly credit)</FONT><BR> </TD> </TR> <TR> <TD> <FONT FACE="Arial" SIZE="1"> Reference #1:   <INPUT NAME="ref-1" TYPE="text" SIZE="55"><BR> Contact:            <INPUT NAME="contact-1" TYPE="text" SIZE="15">     Phone number:   <INPUT NAME="phone-1" TYPE="text" SIZE="24"><BR> <IMG SRC="../images/sm-spacer.gif" HEIGHT="10" WIDTH="2"><BR> Reference #2:   <INPUT NAME="ref-2" TYPE="text" SIZE="55"><BR> Contact:            <INPUT NAME="contact-2" TYPE="text" SIZE="15">     Phone number:   <INPUT NAME="phone-2" TYPE="text" SIZE="24"><BR> <IMG SRC="../images/sm-spacer.gif" HEIGHT="10" WIDTH="2"><BR> Reference #3:   <INPUT NAME="ref-3" TYPE="text" SIZE="55"><BR> Contact:            <INPUT NAME="contact-3" TYPE="text" SIZE="15">     Phone number:   <INPUT NAME="phone-3" TYPE="text" SIZE="24"><BR> <IMG SRC="../images/sm-spacer.gif" HEIGHT="10" WIDTH="2"><BR> </FONT> </TD> </TR> <TR> <TD><U><FONT FACE="Arial" SIZE="2">Equipment Information</FONT></U></TD> </TR> <TR> <TD> <FONT FACE="Arial" SIZE="1"> Equipment to Purchase:      <INPUT NAME="equipment" TYPE="text" SIZE="47"><BR> Equipment dollar amount:   <INPUT NAME="equip-cost" TYPE="text" SIZE="10">     Lease term:     <INPUT NAME="lease-term" TYPE="text" SIZE="2">months<BR> <IMG SRC="../images/sm-spacer.gif" HEIGHT="10" WIDTH="2"><BR> <INPUT NAME="save-info" TYPE="radio" VALUE="YES"> Save my information for future purchases at The Expo<BR> <IMG SRC="../images/sm-spacer.gif" HEIGHT="10" WIDTH="2"><BR> </FONT> </TD> </TR> </TABLE> <INPUT TYPE="submit" VALUE="Submit"><INPUT TYPE="reset" VALUE="Clear"><BR> <IMG SRC="../images/sm-spacer.gif" HEIGHT="10" WIDTH="2"><BR> Or, if you've printed this form, sign here:   _______________________________________________ </FORM> </FONT> </TD> </TR> <TR VALIGN=bottom> <TD> <IMG SRC="../images/sm-spacer.gif" HEIGHT=10 WIDTH=2><BR> <CENTER> <A HREF="http://automotivetools.com" TARGET="top"><IMG SRC="../images/footer1.gif" ALT="Home Page" BORDER=0></A><IMG SRC="../images/footer2.gif" ALT="AutomotiveTools.Com" BORDER=0></A><A HREF="mailto:ruthann@automotivetools.com"><IMG SRC="../images/footer3.gif" ALT="Send Email" BORDER=0></A><BR> </CENTER> </TD> </TR> </TABLE> </BODY>