Application Authorization and Disclosures
By signing below, the undersigned certifies that the information supplied in this application is accurate and complete to the best of their knowledge and that they are authorized to submit it on behalf of the applicant business.
The applicant authorizes Advanced Medical Incorporated (AMI) to contact the applicant and verify information provided in this application, including requesting supporting documentation, for the purpose of evaluating business financing eligibility. Any credit bureau inquiry, personal credit check, or personal guaranty will require a separate, appropriately worded authorization where applicable.
Submitting this application does not guarantee approval, reserve equipment, or establish a financing agreement. Any approval, down payment, interest or finance charge, repayment schedule, late fees, security interest, or rent-to-own terms will be stated in a separate written agreement for the applicant's review and acceptance. No payment authorization is granted by signing this application.
Privacy and Secure Submission Notice
AMI will use information submitted with this application for evaluating and administering a potential financing relationship and may share it with service providers or financing partners as necessary and permitted by law. AMI takes reasonable measures to safeguard applicant information, but no transmission or storage method is completely risk-free. Submit sensitive documents only through an AMI-approved secure channel. Please do not include complete banking credentials, card numbers, or government identification numbers in this form or in ordinary email. If a Federal EIN is needed, our team will request it through a secure channel.
If electronically signed, the signer agrees that their electronic signature is intended to authenticate this application, subject to applicable law.
