BROKER APPLICATION

Become an ACG lease broker.

Tell us about your company, its owners and a lender you work with. Once you are set up, you submit deals and follow them to funding in the broker portal.

Fields marked * are required.

Company

Company name

DBA

Address

City

State

Zip

Phone

Website

Equipment finance associations

Estimated annual funding

Federal tax ID

Portal account

The email and password you will sign in with. Credit decisions and funding notices go to the credit and funding emails if you give them.

Portal sign-in email

Portal password

Retype password

Credit email

Funding email

Owner

First name

Last name

Home street

Home city

Home state

Home zip

Social Security number

Lender you work with

A lender who funds your deals now. We use it as a reference.

Contact name

Company

Phone

Estimated annual funding

Length of relationship

Consent and authorization

Consent and Authorization for Credit Report

The undersigned broker (hereinafter "broker") expressly authorizes American Capital Group (hereinafter "ACG") to obtain, directly or through an agent or its assignees, the broker's credit, background, and financial responsibility reports ("Reports") from any appropriate Reporting Agency and understand that such Reports may be used by ACG in the determination of whether or not to enter into an agreement with broker.  Broker understands that such investigations may include seeking information as to the background, credit and financial responsibility of broker's officers and principals, or any of them.  Broker understands and consents that its credit information may be transmitted via the Internet, that such information may be accessible by unintended 3rd parties, that it is being submitted at our own risk, and that broker waives any right to any punitive damages arising out of or associated with the transmission, interception, use or misuse of the application. Broker may request the status of this application to be transmitted by electronic mail and Broker expressly authorizes ACG or its nominee(s) to transmit such message to the electronic mail address, which Broker may provide.   Broker hereby consents to allowing ACG to obtain any and all Reports from any and all appropriate Reporting Agencies and agrees that such information maintained by such Reporting Agencies will be supplied to ACG and/or any other companies which subscribe to said services.  Broker therefore authorizes the procurement of said Reports by ACG and, if broker enters into an agreement with ACG, broker understands that this authorization shall remain on file and shall serve as on-going authorization for ACG to procure additional Reports at any other time during the agreement.

I agree to the Consent and Authorization for Credit Report above.

Become an ACG lease broker.

Company

Portal account

Owner

Second owner

Lender you work with

Second lender

Consent and authorization