Email Address*
Legal Name Of The Organisation*(This will be the entity that will be the Credit)
Legal Address*
Total Amount to be Financed*
Currency*GBPUSDAUDSGP
CountryUnited KingdomSpainGermany
Finance Term & Structure*(i.e. 24, 36, 48 months, etc.) & (i.e. fair market value structure or capital finance)
Finance Start Date*(i.e. anticipated deal close date)
Physical Address(s) where assets will be located*(Please list Country, State, Province, City, Street Address etc. as applies. Attach if necessary)
Bill of Materials Involved / Detail of Assets and/or Services Financed*(i.e. Hardware, Software, Services, Support involved or End User Quote Detail)
Customer Type*
(Public (If Public – please provide stock symbol), Private, Government, etc.)*
For Private: Organization Financials – Most Recent 3 Years and any Quarterly Interims.*(Required for End User Credits on Opportunities Greater than €100,000)
Non-Standard Structure Requirements*(i.e. delayed payment, step payment, balloon payment, purchase lease back, etc.)
Any Other Deal Specific Requirements*
Ingram Micro Representative Contact Information*
Reseller / Integrator Representative Contact Information*