Franchise Finance Credit Application
Franchisee's Legal Name
d/b/a
City
State
Zip Code
Corporate Name for New Location (If Applicable)
Address of New Shop/Equip Location
FUTURE EXPANSION
AUTHORIZATION FOR DISCLOSURE OF CREDIT INFORMATION
Because I have applied to Petroleum & Franchise Capital (PFC) for financing, I hereby authorize you to disclose to PFC the personal and/or business set forth in attached enclosures. I further authorize Franchisor to disclose any credit, advertising, or royalty payment information which may be requested by PFC. I hereby represent to PFC that such information is true, correct and complete. A photostat copy of this authorization shall be valid as the original. This authorization will expire ninety (90) days from the date set forth below.
If my application for business credit is denied, I have the right to a written statement of the specific reasons for denial. To obtain the statement, I will contact Operations Manager, PFC, 33 Mill Plain Rd., Danbury, CT 06811 or call (203) 778-1000 60 days from the date I am notified of your decision. You will send me a written statement of reasons for the denial within 30 days of receiving my request for the statement.
Notice: The federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applications 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 the law concerning the creditor is the Federal Trade Commission, Equal Credit Opportunity, Washington, DC 20580.
The undersigned agrees that PFC has the right to confirm the accuracy of the above referenced credit information and that PFC has the right to accept or reject this lease application. I irrevocably authorize you to execute and file any UCC financing statement in your name which relates to this transaction.
Please read the following terms and conditions carefully before submitting application. This is a legal document between PFC and you. 1.General. This agreement, together with any such additional terms and conditions, are hereinafter referred to as this “Agreement”. PFC reserves the right, in its discretion, to change or modify all or any part of this Agreement at any time, effective immediately upon the posting thereof on the Web Site. You are responsible for regularly reviewing these terms and conditions. If at any time you find that the terms and conditions of this Agreement are no longer acceptable, you should immediately cease all use of the Service. 2. I hereby understand that by submitting this form I am executing this Agreement with PFC and accept all of the terms and conditions of this Agreement and agree to be legally bound thereby.