Please Complete This Application as Fully as Possible

Contact Name *

First

Last

Contact Cell Phone

Contact Email *

Email

Confirm Email

Guarantor(s)

Principal #1 Name *

First

Last

% Ownership *

Social Security Number *

Principal #1 Home Address

City

State- Select-AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and Labrador.Northwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon

Zip Code

Principal #1 Phone

Principal #1 Cell Phone

Principal #1 Driver’s license number *

Drivers License State-Select-AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon

Date Of Birth *

Email *

Email

Confirm Email

Principal Owner #2

Principal #2 Name

First

Last

% Ownership

Social Security Number

Principal #2 Home Address

City

State-Select-AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon

Zip or Postal Code

Principal #2 Phone

Principal #2 Cell Phone

Driver’s license number

Drivers License State

Date of Birth

Email

Email

Confirm Email

Dealer, Manufacturer or Other Seller

Dealer / Contractor Name

If no dealer, enter NONE.

Dealer Address

Dealer City

Dealer State-Select-AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon

Delaer Zip Code

Dealer Contact

First

Last

Dealer Contact Phone

Dealer Contact Cell Phone

Dealer Email

Email

Confirm Email

Vessel Description

Builder / Manufacturer

Type of VesselTugBargeCrew BoatSupply BoatTanker BoatFishing VesselPatrol - Security VesselsPassenger VesselsCargo VesselsOther

Year, Model and LOA

Engine(s) Manufacturer and Horsepower

Number of Engines

• Single
• Twin
• Triple
• Quad

Fuel

• Gas
• Diesel

Boating Experience (Please describe other boats owned)

Total Cost

Preferred Finance Structure

• Capital Lease
• Operating Lease
• EFA (Equipment Finance Agreement)
• Other (Please Specify Below)

Other Desired Finance Structure

Term Requested-Select-3 yr5 yr7 yr10 yr15 yr20 yr25 yr

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Notes

CERTIFICATION, CREDIT RELEASE AUTHORIZATION, UCC FINANCING STATEMENT APPROVAL, CREDIT HISTORY AND COMMUNICATION I hereby certify that the information contained in this credit application is true and accurate and I hereby authorize our banks and financial institutions to release credit information to Workboat Capital ("WBC"). In states where permissible, I hereby authorize the filing and recording of UCC financing statements showing Workboat Capital's interest in all the business assets and grant WBC the right to execute them in our company name. I hereby authorize WBC and its affiliates, successors and/or designees (and any assignee or potential assignee thereof) and any lending source to whom this application is submitted to obtain consumer credit reports relating to individual credit history and/or creditworthiness. Such authorization shall extend to obtaining a credit profile in considering this application and subsequently for the purposes of update, renewal or extension of such credit or additional credit and for reviewing or collecting the resulting account. By signature below, I/we affirm my/our identity as the respective individual(s) identified in this application. I hereby consent to the receipt of promotional, advertising and other marketing materials from WBC or its agents via email, facsimile, telephone or text message. I understand that my information will not be sold or shared by WBC with any unrelated third party and that I may unsubscribe or opt-out of any such further communications from WBC at any time by following the instructions in the communication (if applicable) or by contacting WBC at [email protected] or by 954-522-3773 Monday-Friday between the hours of 8am-5pm EST. A photocopy, facsimile, or copy of this Marine Credit Application transmitted by email and/or other electronic means shall be valid as the original.

Signature and Date

Clear Signature

Signature and Date

Clear Signature

[email protected] - Phone: 954-522-3773

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