Lease Application "*" indicates required fields EmailThis field is for validation purposes and should be left unchanged.Customer:Legal Name*Contact Name*Phone No.*Trade Name (if applicable)Fax No.Business AddressCity*State*Zip Code*Email Address* Type of Business*Select Type of BusinessProprietorshipCorporationGeneral PartnershipLimited PartnershipLimited Liability CompanyState or Local GovernmentYears Company In BusinessTax Identification No.Principal #1:Name and Title*Home Address*City*State*Zip Code*% of Ownership*Social Security No.*US Citizen?Select CitizenYesNoHome Phone No.Principal #2:Name and Title*Home Address*City*State*Zip Code*% of Ownership*Social Security No.*US Citizen?Select CitizenYesNoHome Phone No.Equipment Supplier:Business Name*Contact Name*Phone No.*Business Address*City*State*Zip Code*Email Address* Fax No.Equipment:Equipment Location check if same as Lessee’s address Credit Requested $*Enter Equipment LocationQuantity*Make and Model*General Description check if equipment is used Key Terms:Lease/Loan Term Months*Purchase Option PriceSelect PriceFair Market ValueEstimated Fair Market Value % of the total Equipment CostNominal Price of $Nominal Price % of the total Equipment CostReferences:Bank*Account No.*Contact Name*Phone No.Trade Creditor*Account No.*Contact Name*Phone No.Secured Debt or Lease Creditor*Account No.*Contact Name*Phone No.Each individual signing below certifies that the information provided in this credit application is accurate and complete. Each individual signing below authorizes you or any lender or funding source which may be utilized (collectively referred to as “Lenders”) to obtain information from the references listed above and obtain a consumer credit report that will be ongoing and relate not only to the evaluation and/or extension of the business credit requested, but also for purposes of reviewing the account, increasing the credit line on the account (if applicable), taking collection action on the account, and for any other legitimate purpose associated with the account as may be needed from time to time. Each individual signing below further waives any right or claim in which such individual would otherwise have under the Fair Credit Reporting Act in the absence of this continuing consent.Printed Name*SignatureDate MM slash DD slash YYYY Printed Name*SignatureDate MM slash DD slash YYYY Δ