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Barco Application

ENTERTAINMENT EQUIPMENT FINANCING

Bank name:

Principal's full legal name:

Company title:

% Ownership:

Social Security #:

Date of birth:

Home Street Address:

City:

State:

Zip Code:

Rent or Own?:

Mobile Phone:

Print Name:

Date of birth:

Attachment:

Leave this empty:

Your legal name

Your email address

Please Confirm full name and signature.

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I agree that I am and I agree this is a legal representation of my signature for all purposes just the same as a pen-and-paper signature

I agree that I am and I understand this is a legal representation of my signature

Signed by Alan Garretson
Signed On: March 1, 2023

Timestamp

Audit

February 27, 2023 11:43 pm CST

Barco Application Uploaded by Alan Garretson - info@fx-financial.com IP 27.255.250.8