oceans_logo
ONLINE CUSTOMER APPLICATION
 
For questions regarding this application please call
800-974-1887
 

If your prefer to print an application and fax it to us you can do so by clicking Application

 
CUSTOMER INFORMATION
Customer (Full Legal Name)
Tel No.
Fax No.
Email
Trade Style/DBA
Nature of Business
Headquarters Address
City
State
Zip Code
Address for this Equipment
City
State
Zip Code
How long in business?
Estimated Installation Date
Who Should Oceans Contact?
Check ONE: Corporation Date of Inc. State of Inc.
Not for Profit
 Date of Inc. State of Inc.
Proprietorship Limited Partnership Genertal Partnership
State or Local Govt Limited Liability Co LLP
 
Officer/Owner Information
Officer/Principal/Owner Title SS#
Complete Home Address City, State, Zip
Officer/Principal/Owner Title SS#
Complete Home Address City, State, Zip
BANK INFORMATION
Bank Name Contact Name Phone No. Fax No.
Account Type Account Number Date Opened
Bank Name Contact Name Phone No. Fax No.
Account Type Account Number Year Opened
TRADE REFERENCES
Company
Contact Name
Phone No.
Fax No.
No. Year
Company
Contact Name
Phone No.
Fax No.
No. Year
EQUIPMENT (Check One)
New Used    Describe Equipment:
Equipment Dealer
Equipment Cost $
Phone
Installation/Freight $
FAX
Sales Tax $
Dealer Contact
TOTAL $
By signing below, the undersigned, who is either a principal of the credit applicant or a personal guarantor of its obligations, provides written instruction to Oceans Capital and/or its designees (and any assignee or potential assignee thereof) authorizing review of his/her personal credit profile from a national credit bureau. Such authorization shall extend to obtaining a credit profile in considering this application and subsequently for the purpose of update, renewal or extension of such credit or additional credit and for reviewing or collecting the resulting account. A photostat or facsimile copy of this authorization shall be valid as the original. By signing below I/we affirm my/our identity as the respective individuals/s identified in the above application. We hereby authorize the release of information requested by Oceans Capital regarding our bank and trade relationships.
By: Title: Date: