888-448-5788
 
     
 
Fill out the brief application form below and we will contact you when a credit decision has been made.

If you would like to speak with a sales representative immediately please use our click to call feature for a toll free call or gives us a call at 888-448-5788.

If you would like to send us an email please click here.


Please include all applicable information

Email:*  
Sales Representative:  
     
Business Information    
Company Name:*  
Doing Business As (DBA)  
Address:  
Address:  
City:  
State / Zip:  
Company Phone:*  
Contact Name:  
Contact Email:  
Contact Phone:  
Contact Phone Ext:  
Fax:  
Business Structure  
Date Company Formed  
Federal Tax ID  
Comments:  
     
Finance Details    
Amount:  
Equipment Description  
Is Equipment New or Used?  
Vendor Company Name:  
     
Principal(s) / Ownership    
Title:  
First Name:*  
Last Name:*  
Ownership %:  
Social Security #:*  
Street Number (Home)  
Street Name (Home)  
Street Type (Home)  
City:  
State / Zip:  
Phone:  
     
Bank References    
Bank Name:  
Phone:  
Fax:  
Account Type:  
Account Number:  
   
Company authorizes Landmark Financial Corp. ("LFC") or its designee to undertake a thorough credit investigation (including credit reporting agencies) for the purpose of financing equipment.  Company hereby gives all their creditors permission to provide LFC the information LFC deems necessary and appropriate to complete its credit evaluation process
     
   

Download a PDF version of our Credit Application here.


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