	Financing Request
	Assets Financed
	Financing Plans
	Financing Process
	Evaluation Criteria
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Site Home > Formal Lease Program Home > GS $Mart Program Home > Financing Request

This online application is provided for your convenience, and will enable us to expedite the processing of your request. Please be as specific as possible in completing this form and when finished select the "Submit" button below. You will receive a response within 48 hours. For additional information, please contact a Finance Representative at 1-877-776-2271; Monday - Friday, 8:30 AM - 5:00 PM.

For additional information, please contact a Finance Representative at 1-877-776-2271; Monday - Friday, 8:30 AM - 5:00 PM.

GS $Mart� Customer Information:


Your Name :
Your E-Mail Address :
Campus Name :
Phone Number :
Fax Number :	optional

If we have questions, how would you prefer to be contacted?

	E-mail Phone
	Morning Afternoon

Underwriting Information:

Purpose of Acquisition :	Financing Transaction
	Planning Numbers

Please describe the asset being financed and its importance relative to your operation



The asset being replaced has been in service:	Years

What is/are the source(s) of repayment for the proposed financing?


Has your Agency ever defaulted on any lease, bond or bond covenant or ever non-appropriated for a lease?	Yes No


Financing Information:
Equipment Cost $:
Finance Amount $:	(Up to 100% of Cost)
Date of Acceptance (est.) :	or mm/dd/yyyy

Desired First Payment Date :	or mm/dd/yyyy
Payment Frequency :
Desired Payment Type:

ADDITIONAL COMMENTS :





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