apply.timepayment.comVendor Application

1-800-872-1532 [email protected] Mon-Fri 8:00am-8:00pm ET Please complete the to begin the process of becoming a TimePayment Vendor. indicates required fields Timepayment Rep: Vendor Information Legal Business Name: DBA Name: Street Address: Address Line 2: City: State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code: Equipment Type: ATM Auto Repair Equipment Cleaning Coffee Computer Construction Copier Credit Card Drones Embroidery Energy Management Engraving Event Decor & Equipment Fitness Food Service Furniture Generators Grooming HVAC Health Care Landscaping Laundry Livestock Material Handling Mortuary Equipment Multimedia Office Other/General Equipment Photography Point of Sale Systems Pottery Printing Recreational Refrigeration Salon School & Daycare Equip Security/CCTV Sign Software Telecommunications Tools Vending Water Quality Woodworking Promo Code: Contact First Name: Contact Last Name: Primary Phone: Secondary Phone: Email: Business Type: Corporation Limited Liability Company Partnership Sole Proprietorship Federal Tax ID: Time in Business: Years Months Annual Sales Volume: Under $1,000,000 $1,000,000: $5,000,000 $5,000,001 and up Principal Information Would you like to submit Principal information for review? This information is often required for the evaluation of prefunding options when business credit has not been established. Program restrictions apply. Yes, I want to add my Principal Information No, I want to proceed with a Business-Alone (Federal Tax ID Required) First Name: Last Name: Home Address: Home Address Line 2: City: State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code: Email: Primary Phone: Secondary Phone: Social Security #: Title: Authorizations, Representations, and Warranties Please review the statements below and click the "I Agree" button for each one. I Agree I hereby authorize and consent to TimePayment Corp. (hereinafter, 'TPC') and its affiliates, regarding both this application, along with any resulting Customer account application, to investigate and/or obtaining credit reports, employment history, trade references and other information - including information that would validate the authenticity of my company's bank account, which I may be providing to TPC for the purpose of TPC funding my company on approved equipment lease, equipment rental, software rental, monitoring service, or transactions. I Agree As the applicant vendor seeking funding from TimePayment ('TPC') and seeking access to TPC's InfoHub portal (applicant vendor hereafter referred to as 'I,' 'my,' or 'my company'), I hereby certify that the information provided above is true and I agree that I, and any and all of my employees, sales representatives, and agents whom I may create an additional InfoHub user profile for ('Additional Users'), shall safeguard my InfoHub password and access to my account. I and my Additional Users further agree to indemnify and hold TPC harmless from any and all damages, losses, and liabilities incurred or suffered as a result of, or incident to, any action by persons other than TPC's employees. I and my Additional Users also agree to use the InfoHub system only for its stated purpose and that failure to do so may result in the immediate termination of my company's access to InfoHub. I Agree I hereby warrant and represent that: (a) When I, or my Authorized Users, receive signed applications for prospective TPC equipment lessees, equipment renters, software renters, or, if applicable, subscribers of alarm monitoring services (all herein referred to as, Customers), such customers credit applications shall authorize TPC to perform a credit check on those Customers and (b) to the best of my knowledge, the information provided in the Customer credit application shall not be false, inaccurate, or misleading. Authorized Signer's Name: Authorized Signer's Title Date Signed I Agree to adopt this typed representation of my name as my signature. By submitting this application I will be completing the signing process and this application will be submitted for credit approval. I agree that this will be an electronic representation of my signature. I further understand that by completing the signing process and submitting this document for credit approval, it will have the same legally binding effect as signing my signature using a pen and paper. © TimePayment 2020, 1600 District Avenue, Suite 200, Burlington, MA, 01803-7555. Terms & Conditions | Privacy Policy For California Customers: https://timepayment.com/ca-privacy-notice/...