Fill out the form below to request the floorplan line of credit, and we will be in touch! If you have any questions don’t hesitate to email us. Dealer Credit Application - Inventory Finance Total Credit Limit Requested: Brands: Usage Allocation Stock Inventory $ Rental Inventory $ Dealer Information Legal Name: DBA Name(s): Federal Tax ID Number: Entity Type: State of Incorporation: Incorporation Date: Number of Years Under Current Management: Contact Information Contact Name: Phone: Email: Fax: Website: Inventory Location Address City: State: Zip Code: Is location owned or rented?OwnedRented Monthly rent? Location owner's name? Owners Name: Title: Ownership %: Address City State ZIP Code: DOB: SSN: Phone: Email: *If the company has more than 4 owners, please provide all the information. Ownership/Corporate Structure Corporation Sole Prop. Subchapter S Partnership Limited Liability Select One: Parent/Holding Company Name: Address: Affiliate Name #1 Address: Affiliate Name #2 Address: Affiliate Name #3 Address: Manufacturer Relationships Manufacturer Name: Contact Name: Phone Number: Since: Inventory Finance Relationships (1) Lender Name: Established Date: Replacing Existing Line:Please select... Yes No Current Limit: $ Balance: $ Type of Inventory Financed: Reason for Replacing Source: Dealer and Business Affirmations Are you or the business(es) involved in any pending or active lawsuits?YesNo Please explain: Do you or the business(es) have any closed judgements (>$25K or <10-years since released)?YesNo Please explain: Do you or the business(es) have any pending or open judgements?YesNo Please explain: Do you or the business(es) have any satisfied or opened liens?YesNo Please explain: Are any dealer principals contemplating filing or ever filed bankruptcy?YesNo Who: Date Filed: Current Status: Please explain: Are any of the business(es) contemplating filing or ever filed bankruptcy?YesNo Who: Date Filed: Current Status: Please explain: Are any of the dealership’s management ever filed bankruptcy?YesNo Who: Date Filed: Current Status: Please explain: Consent Personal Information and Signature: The undersigned confirms that the above information is true and correct. In addition, it authorizes ZAXIS Finance (hereinafter referred to as ZAXIS) to request and exchange any information regarding solvency, particularly with respect to applications to credit bureaus and their full disclosure, at any time. The undersigned acknowledges that ZAXIS has a serious and legitimate interest in collecting personal information about the applicant from third parties in order to operate its business. They acknowledge the fact that ZAXIS can build a file with the personal information collected. The file thus constituted will be kept at one of ZAXIS's places of business and may only be consulted by authorized persons. The undersigned authorizes all parties contacted to release credit and financial information. First Name: Last Name: Date: Privacy Policy