Mazak Online Finance Application.

Thank you for completing the online financing application. A member of MCC Credit Group will be in contact with you regarding your application. Should you need to speak with a member of our team, please call (859) 342-1311 or send an email.

Mazak Online Finance Application Form

Please complete this form. A printable version is also available. Required fields are marked with an asterisk(*).

Company Contact Information
Value is too long
Company name field is required
Value is too long
Street number field is required.
Value is too long
Street name field is required.
Value is too long
Value is too long
Value is too long
City field is required
Province field is required
Value is too long
Invalid format
Postal Code field is required

For US applicants, example 12345 or 12345-6789. For Canadian applicants, example A8A 8A8 or A8A 8A8 A8A.

Value is too long
Phone field is required
Phone number format should be (XXX) XXX-XXXX
Value is too long
Invalid phone extension
Value is too long
Fax format should be XXX-XXX-XXXX

Applicant Contact Information

Value is too long
First name field is required.
Value is too long
Last name field is required.
Value is too long
Title field is required
Email is invalid.
Value is too long
Email field is required
Value is too long
Phone field is required
Phone number format should be (XXX) XXX-XXXX
Value is too long
Invalid phone extension
Value is too long
Phone number format should be (XXX) XXX-XXXX
Value is too long
Invalid phone extension
Company Information
Value is too long
Business/Primary Industry field is required
Value is too long
Invalid format
TAX ID field is required

Please enter your Federal Tax ID or BN # in the appropriate format: Federal Tax ID XX – XXXXXXX | BN# XXXXXXXXX | XXXXXXXXX XX XXXX

Value is too long
Invalid date
Years expected
In Business Since field is required
# of Employees field is required
Value is too long
Value is too long
Value is too long
Value is too long
Value is too long
Value is too long
Annual Sales Dollars field is required
Value is too long
Value is too long
Value is too long
Value is too long
Business Type field is required
Value is too long
Principal(s)/Owner(s)

Principal/Owner 1

Value is too long
First name field is required
Value is too long
Value is too long
Last name field is required
Value is too long
Title field is required
Value is too long
Invalid format

Please enter your Social Insurance Number (SIN) in the appropriate format: XXX – XXX – XXX

Ownership % is required
Percent is invalid.

Residential Address of Principal/Owner

Value is too long
Value is too long
Value is too long
Value is too long
Value is too long
Value is too long
Invalid format

For US applicants, example 12345 or 12345-6789. For Canadian applicants, example A8A 8A8 or A8A 8A8 A8A.

Add Principal/Owner
Equipment
Value is too long
Value is too long

Equipment Location

-
-
Value is too long
Street number field is required.
Value is too long
Street name field is required.
Value is too long
Value is too long
Value is too long
City field is required
Value is too long
Postal Code field is required
Invalid format

For US applicants, example 12345 or 12345-6789. For Canadian applicants, example A8A 8A8 or A8A 8A8 A8A.

Reason for Purchase is required
Value is too long
Reason for Purchase is required
Business Credit Reference

Reference 1

Value is too long
Value is too long
Value is too long
Invalid phone number
Value is too long
Invalid phone extension
Email is invalid.
Value is too long
Add Reference
Equipment Financing Information
Please select rent or own building.
Value is too long
Value is too long
Equipment Sales Price is required
Value is too long
Value is too long
Sales Tax is required
Down Payment is required
Value is too long
Value is too long
Total to be Financed or Leased is required
Value is too long
Value is too long
Lease/Loan Type is required
Days Until 1st Payment is required
Requested Monthly Term is required
Value is too long
Other Term is required
Major Customers (Please list 5) This information is to show sales concentration so that we can better understand your business. We do not contact your customers.
Value is too long
Number is invalid.
Percent is invalid.

Add Major Customer

Additional
Value is too long
If available and applicable, please upload the Machine Quote or Sales Contract, Tax Exemption Certificate, and/or any other confidential documents relevant to this credit application. (File size limit: 3MB per file)
Value is too long
Digital Signature is required
Value is too long
Title/Capacity is required
Date is invalid
Date is required

THE UNDERSIGNED INDIVIDUAL(S) WHO IS EITHER A PRINCIPAL OR PERSONAL GUARANTOR OF THE CREDIT APPLICANT, RECOGNIZING THAT HIS OR HER INDIVIDUAL CREDIT HISTORY MAY BE A FACTOR IN THE EVALUATION OF THE CREDIT HISTORY OF THE APPLICANT OR IN THE EVALUATION OF HIS OR HER PERSONAL GUARANTY, IF APPLICABLE, HEREBY CONSENTS TO AND AUTHORIZES THE USE OF A CONSUMER CREDIT REPORT ON THE UNDERSIGNED INDIVIDUAL(S) BY THE ABOVE NAMED BUSINESS CREDIT GRANTOR AND ITS POTENTIAL AGENTS AND ASSIGNS, FROM TIME TO TIME AS MAY BE NEEDED, IN THE INITIAL CREDIT EVALUATION AND SUBSEQUENT REVIEW PROCESSES.

Value is too long
Principal Signature is required
Value is too long
Title/Capacity is required
Date is invalid
Date is required
Add Principal/Owner Electronic Signature

Mazak Customer Financing collects, uses and discloses personal information about the individual credit history of the principal, sole proprietor, or personal guarantor of the credit applicant, in order to evaluate the credit history of the applicant or to evaluate the individual’s personal guarantee. At any time during the application, and on an ongoing basis thereafter, the personal information provided may be used to: verify the information provided, assess your credit worthiness, obtain a consumer credit report (which may include a criminal background check), establish credit and hold limits, maintain our client relationship, and provide you with other products and services offered or approved by us, our affiliates, related entities or other third party financial partners.

In the course of providing credit financing services to you, we (and our third party service providers) may disclose your personal information to, and receive your personal information from: consumer reporting agencies, credit bureaus, collection agencies, your present and past financial institutions, business and trade references, vendors and customers, landlords and tenants, or any third parties who have information about your financial status,potential purchasers of our business and their advisors, and any third party service providers to whom we may outsource our business and credit functions including third party lenders from whom we obtain financing on your behalf. Mazak Customer Financing and its third party service providers are located in the United States and Canada, and while your personal information resides in the United States it may be accessible to law enforcement and other authorities pursuant to specific lawful requests for information.

By signing this form, you consent and authorize us to collect, use and disclose your personal information at any time during the application, and on an on-going basis thereafter in the initial credit evaluation and subsequent review process, for the foregoing purposes.

For Canadian individual principals, sole proprietors, or personal guarantors, you understand that the provision of your Social Insurance Number ("SIN") is optional and that the processing of your credit application is not conditional on providing you SIN. You understand that choosing not to provide your SIN is likely to increase the time required to process the credit application and may result in Mazak Customer Financing and its third party service providers not receiving current and accurate information about your credit rating.

For more information, see our Privacy Statement or contact us at (800) 668 5449 (for Canada only) or in USA the Toll Free Number: (877) 634-5521 or email us at mccgroup@mazakcorp.com.

*Required Information