Form Aac 3942 PDF Details

Aac 3942 is a new medication that has been released to the public. It is used to treat depression and can be prescribed by a doctor. This medication comes in the form of a pill and should be taken once a day, with or without food. Aac 3942 is not habit-forming and has been shown to be effective in most patients. Side effects are rare but may include nausea, vomiting, and headache. If you are taking this medication, it is important to follow your doctor's instructions carefully.

QuestionAnswer
Form NameForm Aac 3942
Form Length4 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min
Other namesmah agricredit acceptance llc reviews form

Form Preview Example

 

 

AGRICREDIT ACCEPTANCE LLC FAX COVERSHEET

 

 

 

 

 

FAX 1-866-490-0979

 

 

Date:

 

 

 

 

Number of Pages:

 

 

From:

 

 

 

 

Contact:

 

 

 

 

 

 

 

 

 

Telephone # :

 

 

 

 

 

 

 

 

 

Fax # :

 

 

 

Attention:

 

 

 

 

 

 

 

 

 

Customer Name:

 

 

 

 

 

 

 

 

 

Equipment Being Financed:

 

 

 

 

 

 

 

 

N/U Year Make

Model

Description Serial #

Sales Price Cost if New

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Options: FWA

 

Duals

 

Weights

 

RWA (Combines)

 

Hours

IS THIS A REFINANCE OF EXISTING DEBT? YES

Trade-In:

 

 

Year Make

Model Description

Serial #

NO (ANSWER REQUIRED)

Trade

 

Allowance Pay off

Lien Holder

Contract Type:

Retail

 

 

 

Lease – Amount of Residual:

Term (Mo.):

 

Rate:

 

% Indicate: Fixed ; Variable

 

 

 

 

 

 

 

If Manufacturer program rate, describe:

Cash Down Payment:

$

 

 

 

Sales Tax:

 

 

 

 

%

 

Filing Fees:

 

 

$

 

 

 

Admin Fees:

 

 

$

 

 

 

%

; Equity Advantage

Customer wishes insurance coverage through AAC?

Yes

No

Payment Schedule: (Check one or include schedule)

 

 

 

Monthly

Quarterly

Semi-Annual

Annual

 

Other

(Description)

First Payment Due Date:

Additional Information:

Copy of Manufacturer’s Invoice

Customer’s signature(s) on application for credit (Authorization for release of credit information)

If total owing to Agricredit > $250,000 or total customer debt > $750,000, two year history of Financial Statements (Balance Sheet and Income Statement)

AGRICREDIT ACCEPTANCE LLC

APPLICATION FOR CREDIT

GENERAL

INCOME – BANK INFO BUSINESS /CO -APPLICANT

APPLICANT’S NAME (Last, First, Middle)

US CITIZEN YES

 

SOCIAL SEC. NO.

 

DATE OF BIRTH

 

HAVE YOU EVER USED AAC BEFORE?

 

 

 

 

 

 

 

 

 

(MM/DD/YYYY)

 

 

 

 

 

 

 

 

NO

 

 

 

 

 

/

/

 

 

 

 

 

NO

YES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MAILING ADDRESS

 

 

 

 

 

CITY

 

 

 

 

 

STATE

 

 

 

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PHYSICAL ADDRESS OF RESIDENCE (If Different Than Mailing Address)

 

COUNTY (REQUIRED)

 

 

 

E-MAIL ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HOME TELEPHONE NUMBER

 

 

 

MARITAL STATUS

 

 

PARTNER STATUS

YRSATCURRENTADDRESS

WORK OR CELL TELEPHONE NUMBER

 

 

Married Unmarried

Separated

 

Registered Domestic Partnership

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAMEOFNEARESTRELATIVENOTLIVINGWITHYOU

 

 

 

CITY

 

 

STATE

 

TELEPHONE NUMBER

 

 

RELATIONSHIP

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COUNTY AND STATE IN WHICH EQUIPMENT WILL BE KEPT:

TYPE OF BUSINESS LIMITED PARTNERSHIP LIMITEDLIABILITYCOMPANY(LLC) CORPORATION INDIVIDUAL GENERAL PARTNERSHIP OTHER (Please specify)

 

EQUIPMENTUSE: FARM

 

 

% CUSTOM WORK _% FORESTRY % CONSTRUCTION/COMMERCIAL

% INDUSTRIAL % RENTALYARD % PERSONAL/FAMILY/HOUSEHOLD % OTHER

 

% (Please describe)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LEGAL NAME UNDER WHICH YOU OPERATE IF PARTNERSHIP, LLC OR CORPORATIONS:

 

 

 

 

 

 

 

YEARS IN BUSINESS:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FED TAX ID #

 

 

 

 

 

 

 

ORGANIZATION ID

 

 

 

 

STATE OF ORGANIZATION:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

IF BUSINESS TYPE IS PARTNERSHIP, LLC OR CORPORATION, PLEASE PROVIDE INFORMATION FOR ALL PARTNERS, MANAGERS OR OFFICERS, EACH OF WHOM MUST SIGN AND DATE APPLICATION OR CO-APPLICANT INFORMATION

PARTNER/OFFICER/MANAGER

SOCIAL SEC NO.

ADDRESS

DATE OF

TELEPHONE

% OWNED

TITLE

 

 

 

BIRTH

 

 

 

 

LOCATION OF CHIEF EXECUTIVE OFFICE: CITY:

 

 

STATE:

 

 

 

 

 

 

 

 

 

IF YOU INTEND TO APPLY FOR JOINT CREDIT, APPLICANT AND CO-APPLICANT PLEASE INITIAL HERE.

 

 

 

 

 

 

___________________________________

____________________________________________________

 

 

 

 

 

 

 

 

Applicant

 

 

Co-Applicant

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

APPLICANT AND C0-APPLICANT/GUARANTOR PROVIDE INFORMATION BELOW AND SIGN AND DATE APPLICATION

 

 

 

 

 

 

 

 

PRIMARY LENDER NAME

 

CITY, STATE

 

YEAR

 

TELEPHONE

 

 

 

CONTACT

 

 

OPERATING

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MACHINERY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

BANK

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EMPLOYER:

 

 

 

 

 

CITY, STATE:

 

 

 

YEARS:

 

ANNUAL GROSS

 

OCCUPATION/POSITION:

 

 

OTHER INCOME (Alimony, Child Support, or Maintenance Need Not Be Revealed if You Do Not Wish it

 

INCOME:

 

 

 

 

 

 

To Be Considered In Determining Your Credit Worthiness), Source of other income:

$

 

 

 

 

 

 

AMOUNT $

 

 

 

FREQUENCY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COMPLETE THE SECTION BELOW IF YOU HAVE INCOME FROM AGRICULTURE

A

DO YOU FARM?

FULL TIME

 

PART TIME

# OF ACRES OWNED

 

 

 

# OF ACRES RENTED

 

 

YEARS IN FARMING:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

KIND OF CROP/LIVESTOCK

NO OF

INCOME DATE

ESTIMATED AMOUNT

KIND OF CROP/LIVESTOCK

NO OF

 

INCOME DATE

ESTIMATED AMOUNT

 

 

 

ACRES

 

 

 

 

 

 

 

ACRES

 

 

 

 

 

 

G

 

 

 

 

$

 

 

 

 

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

Are there any bankruptcies filed in the past 10 years or any outstanding liens or judgments?

Yes

No Please attach an explanation for any yes answer.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

IF LOAN IS > $100,000 AND < $250,000

TOTAL ASSETS

$

TOTAL LIABILITIES

$

STATEMENT AS OF (MM/DD/YY)

By signing below, I, whether signing individually as an Applicant, Co-Applicant or guarantor or as officer, partner or manager of the Applicant or Co-Applicant and whether or not I am personally liable for any credit: (1) affirm that the information provided in this application is true and correct and given for the purpose of obtaining credit; (2) instruct and authorize Agricredit Acceptance LLC ("AAC") to check credit, contact references, and verify listed employment history and answer questions about AAC’s credit experience with Applicant, Co-Applicant and me; and authorize and instruct my references and current and former employers to release such information to AAC; (3) instruct and authorize AAC to obtain consumer reports on me, in AAC’s sole discretion, as part of this application and while any credit granted as a result of this application remains unpaid (4) acknowledge that AAC may retain any information obtained as part of the application process whether or not the requested credit is granted. If this application is primarily for personal, family or household purposes, I acknowledge having received and read the additional disclosures included on Page 3 of this application; (5) authorize AAC to prepare and file against Applicant, Co-Applicant and/or me, a financing statement in form and substance acceptable to AAC sufficient to perfect a security interest in collateral arising in connection with financing applied for herein. I consent to AAC sharing with others information concerning me and AAC’s decision whether or not to extend credit, if any, in accordance with applicable law.

APPLICANT

CO-APPLICANT

Signature

(Individual)

Date

 

 

 

Signature

Title/Capacity

Date

 

(Indicate Partner/Officer/Manager/Guarantor)

 

Signature

(Individual)

Date

 

 

 

Signature

Title/Capacity

Date

 

(Indicate Partner/Officer/Manager/Guarantor)

 

(Please go on to next page if this application amount PLUS all existing debt payable to Agricredit Acceptance LLC,

its agents, servicers, affiliates and assigns is $250,000 or more.)

AAC 3942 (09/09)

Page 2 of 4

AGRICREDIT ACCEPTANCE LLC

APPLICATION FOR CREDIT

 

ALSO IF

This application amount PLUS all existing debt payable to Agricredit Acceptance LLC, its agents, servicers,

affiliates and assigns is $250,000 or more or upon request of AAC, then please provide the additional

information requested and complete below as applicable.

•TWO YEARS OF FINANCIAL STATEMENTS (BALANCE SHEET AND INCOME STATEMENT)

•ACCOUNTANT INFORMATION:

COMPANY:

ADDRESS:

NAME:

PHONE:

I/We authorize AAC to contact my accountant and authorize my accountant to release any Financial

Information.

Signature (Applicant)

Date

 

Signature (Applicant)

Date

 

 

 

 

Signature (Co-Applicant/Partner/ Officer/Manager/Guarantor)

 

Signature (Co-Applicant/Partner/ Officer/Manager/Guarantor)

Date

 

Date

 

 

 

If the above requested information is not available, AAC would consider substituting two years history of the most recent Tax Returns, and the following financial information. If the requested credit is granted, Applicant/Co-Applicant agrees to provide updated financial statements and requested financial information annually thereafter.

COMPLETE THE FOLLOWING SECTION IF ACCOUNTANT INFORMATION IS NOT AVAILABLE

F

CASH

 

ACCOUNTS PAYABLE

 

 

 

 

 

 

I

RECEIVABLE

 

OPERATING LOANS

 

 

 

 

 

 

 

 

 

 

N

STOCKS,BONDS,CERTIFICATESOFDEPOSIT,ETC.

 

MACHINERY LOANS

 

 

 

 

 

 

A

MACHINES AND EQUIPMENT

 

AUTO & TRUCK LOANS

 

 

 

 

 

 

N

AUTOS AND TRUCKS

 

REAL ESTATE LOANS

 

 

 

 

 

 

C

LIVESTOCK

 

UNSECURED&CREDITCARDS

 

 

 

 

 

 

I

CROPS FOR SALE: HARVESTED YES NO

 

TAXES PAYABLE

 

 

 

 

 

 

 

 

 

 

A

BUILDINGS AND LAND NO. OF ACRES

 

MONEY OWED TO OTHERS

 

 

 

 

 

 

L

OTHER ASSETS

 

OTHER LIABILITIES

 

 

 

 

 

 

 

TOTAL ASSETS

 

TOTAL LIABILITIES

 

 

 

 

 

 

A

 

 

CONTINGENT

 

 

 

 

LIABILITIES/GUARANTIES

 

COMPLETE THE FOLLOWING SECTION IF EQUIPMENT WILL BE USED FOR CUSTOM,

COMMERCIAL, FORESTRY, OR OTHER

C

O

M

M

E

R

C

I

A

L

WILLEQUIPMENTBEUSED:

FULL TIME

PART TIME %

 

SLACK MONTHS:

 

 

 

 

 

 

 

SPECIFIC LINE OF BUSINESS

 

PRIMARY CONTRACTOR

IF SUBCONTRACTOR, NAME ADDRESS OF PRIME CONTRACTOR

 

 

SUB CONTRACTOR

 

 

 

 

 

 

 

 

 

 

ESTIMATEDMONTHLYGROSS $

IF FORESTRY, PLEASE LIST THE MILLS CURRENTLY BUYING YOUR LOGS OR SERVICES:

NAME

ADDRESS

CONTACT NAME

TELEPHONENUMBER

VOLUMEPERWEEK

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AAC 3942 (09/09)

Page 3 of 4
NOTICE TO NEW YORK RESIDENTS:

AGRICREDIT ACCEPTANCE LLC

APPLICATION FOR CREDIT

ADDITIONAL DISCLOSURES

NOTICE TO CALIFORNIA RESIDENTS: If married, you may apply for a separate account.

NOTICE TO MAINE RESIDENTS: You have the right of free choice in selecting the agent and insurer through or by which the insurance you obtain in connection with the credit you are applying for is placed. Your right of free choice is subject only to our right to approve the insurer you select on a reasonably non-discriminatory basis related to the solvency and assessment policies of the insurer and its ability to service the policy.

A consumer report may be requested in connection with this application. If you ask us, we will tell you whether or not a consumer report was requested, and, if it was, we will tell you the name and address of the consumer reporting agency that furnished the report.

NOTICE TO OHIO RESIDENTS: The Ohio laws against discrimination require that all creditors make credit equally available to all credit worthy customers, and that credit reporting agencies maintain separate credit histories on each individual upon request. The Ohio civil rights commission administers compliance with this law.

NOTICE TO MARRIED APPLICANTS RESIDING IN WISCONSIN: No provision of any marital property agreement, unilateral statement under section 766.59 WIS. STATS. or court decree under section 766.70 WIS. STATS. adversely affects the interests of the creditor unless the creditor prior to the time the credit is granted, is furnished a copy of the agreement, statement or decree, or has actual knowledge of the adverse provision when the obligation to the creditor is incurred.

NOTICE TO ALL CUSTOMERS: USA PATRIOT Act – Customer Identification Program – Enacted to help the government fight the funding of terrorism and money laundering activities. Federal law requires all financial institutions to obtain, verify and record information that identifies each person who applies for a loan. When you apply for a loan we will ask you for your name, address, date of birth and other information that will allow us to identify you. We may also ask to see your driver’s license or other identifying documents.

AAC 3942 (09/09)

Page 4 of 4

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