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First and Last Name
(Required)
Mobile Phone
(Required)
Email Address
(Required)
Consent for SMS and MMS Alerts
(Required)
I hereby consent to receive SMS (text message) alerts and notifications about my transaction. The number of messages will vary and I may opt-out at any time.
I Agree
Do you have a business name?
(Required)
Yes
No
How will you utilize this equipment?
(Required)
Please Confirm
For a business, as a contractor, or to generate income on the side
For strictly recreational or personal use (financing options may be limited)
Are You a Startup or an Existing Business?
(Required)
Please Confirm
True Startup (Not Yet Running)
Newer Business (Under 2 Years in Business)
Existing Business or Farm (Over 2 Years in Business)
Business Name
(Required)
Business Address
(Required)
Street Address
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
How Many Years Have You Operated Under This Business Name?
(Required)
Please enter a number from
2
to
99
.
Current Employer
(Required)
Your place of employment/main source of income
Will You Continue Your Current Employment?
(Required)
Please Confirm
Yes
No
Who Runs/Will Run The Business While You're Working?
(Required)
How many years have you worked in this industry?
(Required)
Please enter a number from
0
to
99
.
Please describe your background in this business?
(Required)
Who else is involved in the business?
(Required)
Does Your Business Have a Separate Tax ID #?
(Required)
Please Confirm
Yes
No
Yes, but I don't know what it is.
Enter Your Tax ID #
(Required)
What is the total balance you have in cash, checking accounts, and saving accounts?
(Required)
What is Your Ownership Percentage In the Company?
(Required)
Please enter a number from
0
to
100
.
How Many Additional Owners Are There, Excluding Yourself?
(Required)
Please Confirm
1
2
3 or More
Please enter only the three additional owners with the greatest % of ownership.
Additional Owner #1 Name
(Required)
Additional Owner #1 Email Address
(Required)
Additional Owner #1 Phone Number
(Required)
Additional Owner #1 - % of Ownership
(Required)
Please enter a number from
0
to
100
.
Additional Owner #2 Name
(Required)
Additional Owner #2 Email Address
(Required)
Additional Owner #2 Phone Number
(Required)
Additional Owner #2 - % of Ownership
(Required)
Please enter a number from
0
to
100
.
Additional Owner #3 Name
(Required)
Additional Owner #3 Email Address
(Required)
Additional Owner #3 Phone Number
(Required)
Additional Owner #3 - % of Ownership
(Required)
Please enter a number from
0
to
100
.
Have You Financed Equipment in Your Business Name Before?
(Required)
Please Confirm
Yes
No
Make & Model of Desired Equipment?
(Required)
Desired Equipment Cost
(Required)
Please enter a number from
1000.00
to
50000.00
.
Is this an engine or a vehicle?
(Required)
Please Confim
Engine or component on its own
Truck or Vehicle
Is the vehicle it is going in owned free & clear
(Required)
No, there is a lien against it.
Yes, I own it outright.
Please describe the vehicle the engine is going in.
(Required)
List year, make, and model
Name of Equipment Vendor
Note: this program requires you to buy from a dealer, seller, e-commerce site, or brick and mortar store.
Vendor Phone #
Vendor URL or Website
Which rep at Bendpak are you working with?
(Required)
Please Confirm
None or Online Order
Alan Hope
Alex Ladosky
Brittany Delgado
Curtis Evans
Daniel Rodriguez
David Gibson
Dona Soto
Kat Peters
Robert Ladosky
Zack Beliveau
Which rep at Bendpak are you working with?
(Required)
Please Confirm
None or Online Order
Alan Hope
Alex Ladosky
Brittany Delgado
Curtis Evans
Daniel Rodriguez
David Gibson
Dona Soto
Kat Peters
Robert Ladosky
Zack Beliveau
Which rep at Bendpak are you working with?
(Required)
Please Confirm
None or Online Order
Alan Hope
Alex Ladosky
Brittany Delgado
Curtis Evans
Daniel Rodriguez
David Gibson
Dona Soto
Kat Peters
Robert Ladosky
Zack Beliveau
Which location are you buying from?
(Required)
Please confirm
Kansas City
Little Rock
Springfield
→ Please complete the below
Credit Release Authorization
so we can perform a
'SOFT'
credit check.
→ Upon clicking submit, applicant will receive a text and email with a link to complete the
Credit Release Authorization
so we can perform a
'SOFT'
credit check.
Social Security #
(Required)
Home Address
(Required)
Street Address
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
Consent for Credit Release Authorization
(Required)
I (We) authorize Security Leasing Services, Inc. (aka SLS Financial Services), American Equipment Financial Services, LLC, American Leasing & Financial, LencoFinEq, LLC, Opportunity Financial Services, LLC, ExpressLink Capital, LLC, Expresslink Funding, LLC, and/or its assigns and designees to investigate all credit information, including but not limited to consumer credit reports, bank and trade references and accountant information for purposes of processing this lease credit application. Such authorization shall extend to obtaining a credit profile in considering this application and subsequently for the purposes of update, renewal or extension of such credit or additional credit and for reviewing or collecting the resulting account. All principals hereto agree that an electronic copy of this application may be treated as and considered the same as an original. By choosing the Submit For Approval button below, you are giving your electronic signature in agreement with these terms. By providing your contact information, you agree to receive electronic communications from SLS including on an Opt-In basis for SMS and MMS messages to any mobile phone number we have on file for you. I (We) certify that the above information provided is true and correct.
I/we agree that SLS, the broker, My Little Salesman, or their agents or assigns may disclose information about my/our financing application, stage, status, outcome, or other transaction details to the originating vendor, manufacturer, or seller of equipment to help facilitate the equipment sales process.
**Consent to Use of Artificial Intelligence and ChatGPT in Underwriting Evaluation and Processes**
By signing below, you acknowledge and agree that Security Leasing Services, Inc. (aka SLS Financial Services), American Equipment Financial Services, LLC, American Leasing & Financial, LencoFinEq, LLC, Opportunity Financial Services, LLC, and/or its assigns and designees may utilize artificial intelligence (AI) technologies, including but not limited to ChatGPT, as part of the underwriting evaluation and other processes related to your application for credit. You consent to the use of AI in analyzing and processing your credit information, which may include data from consumer credit reports, bank and trade references, and other financial information. This usage is intended to enhance the accuracy and efficiency of our credit evaluation procedures. Your information will be handled in accordance with applicable data protection and privacy laws. If you have any questions or concerns regarding the use of AI in our processes, please contact us for more information.
ECOA NOTICE (TO BE RETAINED BY APPLICANT) Thank you for your business credit application. We will review it carefully and get back to you promptly. 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 that statement, please contact us within 60 days from the date that you are notified of our decision. We will send you a written statement of the reasons for the denial within 30 days of 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 our compliance with this law is the Federal Trade Commission, Equal Credit Opportunity, Washington, DC 20580.
By checking the "I Agree" box and typing my name as Digital Signature, I am indicating the above statements are true and accurate to the best of my knowledge. I hereby agree to the Credit Release Authorization and Verification Terms and Conditions, understanding it may be necessary to complete a review of my credit PRIOR TO receiving terms and payment options.
I hereby agree that this agreement may be electronically signed and that my digital signature appearing on this agreement is the same as a handwritten signature for purposes of validity, enforceability, and admissibility.
I Agree.
Consent for Credit Release Authorization
(Required)
I (We) authorize Security Leasing Services, Inc. (aka SLS Financial Services), American Equipment Financial Services, LLC, Opportunity Financial Services, and/or its assigns and designees to investigate all credit information, including but not limited to consumer credit reports, bank and trade references and accountant information for purposes of processing this lease credit application. Such authorization shall extend to obtaining a credit profile in considering this application and subsequently for the purposes of update, renewal or extension of such credit or additional credit and for reviewing or collecting the resulting account. All principals hereto agree that an electronic copy of this application may be treated as and considered the same as an original. By choosing the Submit For Approval button below, you are giving your electronic signature in agreement with these terms. By providing your contact information, you agree to receive electronic communications from SLS. I (We) certify that the above information provided is true and correct.
I/we agree that the broker, My Little Salesman, or their agents or assigns may disclose information about my/our financing application, stage, status, outcome, or other transaction details to the originating vendor, manufacturer, or seller of equipment to help facilitate the equipment sales process.
ECOA NOTICE (TO BE RETAINED BY APPLICANT) Thank you for your business credit application. We will review it carefully and get back to you promptly. 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 that statement, please contact us within 60 days from the date that you are notified of our decision. We will send you a written statement of the reasons for the denial within 30 days of 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 our compliance with this law is the Federal Trade Commission, Equal Credit Opportunity, Washington, DC 20580.
I consent to the use of electronic disclosures and signatures and they shall be considered the same as physical for all legal purposes.
Applicant Agrees by Phone
Consent for Credit Release Authorization
(Required)
I (We) authorize Security Leasing Services, Inc. (aka SLS Financial Services), American Equipment Financial Services, LLC, LencoFinEq, LLC, Opportunity Financial Services, and/or its assigns and designees to investigate all credit information, including but not limited to consumer credit reports, bank and trade references and accountant information for purposes of processing this lease credit application. Such authorization shall extend to obtaining a credit profile in considering this application and subsequently for the purposes of update, renewal or extension of such credit or additional credit and for reviewing or collecting the resulting account. All principals hereto agree that an electronic copy of this application may be treated as and considered the same as an original. By choosing the Submit For Approval button below, you are giving your electronic signature in agreement with these terms. By providing your contact information, you agree to receive electronic communications from SLS. I (We) certify that the above information provided is true and correct.
I/we agree that the broker, My Little Salesman, or their agents or assigns may disclose information about my/our financing application, stage, status, outcome, or other transaction details to the originating vendor, manufacturer, or seller of equipment to help facilitate the equipment sales process.
ECOA NOTICE (TO BE RETAINED BY APPLICANT) Thank you for your business credit application. We will review it carefully and get back to you promptly. 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 that statement, please contact us within 60 days from the date that you are notified of our decision. We will send you a written statement of the reasons for the denial within 30 days of 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 our compliance with this law is the Federal Trade Commission, Equal Credit Opportunity, Washington, DC 20580.
I consent to the use of electronic disclosures and signatures and they shall be considered the same as physical for all legal purposes.
Credit Release On File
Recorded Verbal Credit Release Authorization
(Required)
Max. file size: 128 MB.
Full Legal Name
(Required)
Having trouble? Call us at
1-316-347-8699
or use the chat function below.
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