Dealer Application Checklist:
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- Donald Gray
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1 Dealer Application Checklist: Completed Dealer Authorization Form o Each owner/principle must sign and date form Completed Credit Application o Signed and dated application with all owners and principal information included Last 2 Fiscal Year End Business Financial Statements o Provide Balance Sheet and corresponding Income Statement o Interim financials with prior year comparative period, if available Personal Financial Statements (no more than 12 months old) o Provide signed and dated copy for each owner and guarantor Formation Documents o Corporation-Articles of Incorporation o Partnership-Partnership Agreement (if applicable) o Limited Liability Company-Articles of Organization/Certificate of Organization and Operating Agreement To ensure all items have been completed on the Credit Application, please use the check list below. Please sign and return this check list acknowledging that the below requirements are included in the application package. Have you included all of the following: 1.) Federal Tax ID #; 2.) Date of ownership (month and year started); 3.) Social Security #(s); and 4.) Percentage Owned? (total must equal 100%) If percentage owned by an additional business entity, has information been provided on that entity according the above checklist? Have all owners/partners/members/officers completed their personal information and signed the application where signatures are required? Have all pages of the application been submitted? To verify your legal business name and structure, have you included a copy of your Articles of Organization or Articles of Incorporation and any Amendments to the foregoing? Signed by: Date:
2 Dealer Authorization Form (the Credit Applicant ) and the undersigned individual(s) (collectively, the Guarantors ), recognizing that their personal credit history may be a factor in the evaluation of the credit worthiness of the Credit Applicant, authorize Northpoint Commercial Finance LLC (together with its affiliates, Northpoint ) and Cycle Express, LLC d/b/a National Powersport Auctions (together with its affiliates, NPA ) to obtain credit and financial information regarding any or all of them from all credit reporting agencies, all banks, and all other companies that either Northpoint or NPA from time to time deems necessary. This authorization includes the right for Northpoint and NPA to disclose such credit and financial information to each other. If Northpoint extends credit to the Credit Applicant, the Credit Applicant and the Guarantors further agree that this authorization shall be ongoing and shall relate not only to the evaluation or extension of the business credit requested, but also for purposes of reviewing the account, increasing the credit line on the account (if applicable), taking collection action on the account, and for any other legitimate purpose associated with the account as may be needed from time to time. The Credit Applicant and the Guarantors waive any claim that the undersigned would otherwise have under the Fair Credit Reporting Act in the absence of this continuing consent. I authorize Northpoint and NPA to correspond with me via facsimile, telephone, and/or any and all other forms of communications until I cancel such authorization by written notice. [ENTER NAME OF BORROWER] X X Printed Name: Printed Title: Printed Name: Residence Address: Equal Credit Opportunity Notice: The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against applicants on the basis of race, color, religion, national origin, sex, marital status, age (provided that 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 Protecting Act. The Federal agency that administers compliance with this law concerning this creditor is the Federal Trade Commission, Equal Credit Opportunity, Washington D.C This is to advise you that if your application for business credit is denied, you have the right to a written statement of the specific reasons for denial. To obtain the statement, please contact the office listed on this letter within sixty (60) days from the date you are notified of our decision. We will send you a written statement of the reasons for the denial within thirty (30) days of your request for the statement.
3 Credit Line Amount Requested ($): Manufacturer/Distributor Name(s) / Products to be financed: National Powersport Auctions / Used powersport products Dealer Information Borrower s Full, Legal Name (please include correct punctuation): Federal Tax ID: Trade Name or DBA (please include correct punctuation): Main Physical Address: Website URL Address: City: State: Zip Code: Address: Mailing Address: Date Current Ownership Acquired Business: City: State: Zip Code: State of Incorporation: Date of Incorporation: Please check the appropriate legal entity: Corporation Limited Liability Company Sole Proprietorship Partnership Other Number of Locations: Number of Employees: Fiscal Year End Date: Primary Contact: Sales Contact: Contacts Operations Contact: Accounting Contact: Principals, Members, Partners or Officers
4 DBA Name: Physical Address/City/State/Zip Code: DBA Name: Physical Address/City/State/Zip Code: Full, Legal Name(s) (please include correct punctuation): Additional Locations of Same Legal Entity Related Entities Address, City, State, Zip: Please check the one that applies to you: Rent Own Landlord / Insurance Information Landlord Name, Address, City, State, Zip: Business Insurance Agent: Name of Agency: Business Bank Accounts Bank Name & Address: Account Information: References Checking # Savings # Loan # Other# Contact: Floorplan/Inventory Finance Sources Company Name: Products Financed: Contact: Company Name: Products Financed: Contact: Trade/Credit References Company Name: Contact: Company Name: Contact: Additional Information Do you have any assets pledged or assigned as collateral for any of your liabilities? Yes No If yes, please give amounts and details. Are there any legal actions pending? Yes No If yes, please explain Has the company, or any principals involved in the company, ever filed for protection under bankruptcy laws? Yes No If yes, please explain Has any principal in the business been convicted of a felony? Yes No If yes, please explain on an attached piece of paper. This application cannot be considered until we receive the following information: 1. Last 2 year-end financial statements on the business 2. Current personal financial statement on each owner/partner If a new business (less than 2 years), please provide the following information: 1. Opening balance sheet on the business and a projected income statement for at least 12 months 2. Resume and personal financial statement on each owner/partner
5 REPRESENTATION AND WARRANTY OF COMPLETENESS AND ACCURACY AND CONSENT TO USE OF A CREDIT REPORT AND TO RECORD UCC-1 FINANCING STATEMENT The above information is provided in order to enable Northpoint Commercial Finance LLC to establish and maintain credit accommodations for the above credit applicant (the Credit Applicant ). The Credit Applicant has read the information provided and represents and warrants the completeness and accuracy of the information as presented. Authorization is granted to Northpoint Commercial Finance LLC (i) to obtain credit and financial information on the Credit Applicant and the undersigned individual(s) (since his or her personal credit history may be a factor in the evaluation of the credit history or credit worthiness of the Credit Applicant) from all credit reporting agencies, all banks and all other companies, which Northpoint Commercial Finance LLC from time to time deems necessary and (ii) to file immediately and prior to any credit approval of the Credit Applicant a UCC-1 financing statement in all offices and jurisdictions Northpoint Commercial Finance LLC deems appropriate naming the Credit Applicant as debtor and indicating the collateral as all assets of debtor or words to similar effect. The filing of such financing statement(s) does not constitute a credit approval or create an obligation for Northpoint Commercial Finance LLC to make any loans or provide any credit accommodations to the Credit Applicant. The undersigned waives any claim which the undersigned would otherwise have under the Fair Credit Reporting Act in the absence of this continuing consent. Business Name: Signed Print Name Title Date X Printed Name X Printed Name X Printed Name X Printed Name Notice: The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against applicants on the basis of race, color, religion, national origin, sex, marital status, age (provided that 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 Protecting Act. The Federal agency that administers compliance with this law concerning this creditor is the Federal Trade Commission, Equal Credit Opportunity, Washington D.C This is to advise you that if your application for business credit is denied, you have the right to a written statement of the specific reasons for denial. To obtain the statement, please contact the office listed above within sixty (60) days from the date you are notified of our decision. We will send you a written statement of the reasons for the denial within thirty (30) days of your request for the statement.
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