Credit Application for Equipment Leasing

Company Ownership Information:
Business Name:
Email Contact:
How long established
under current ownership?
Business Address:
How long at this address?
Phone:
Fax:
Federal Tax ID#:
Type of ownership:
Owners / Principals:
1st Owner / Principal:
1st Owner's SSN:
Percent ownership:
Title:
Home Phone:
Home Address:
2nd Owner / Principal:
2nd Owner's SSN:
Percent ownership:
Title:
 
Home Phone:
Home Address:
Previous Employment
(if in business for less than two years):
Company Name:
Position:
How Long?
Phone:
Trade References:
1st Company Name:
Address:
Phone:
2nd Company Name:
Address:
Phone:
3rd Company Name:
Address:
Phone:
Bank References:
1st Bank Name:
1st Bank Address:
Phone:
Acct#:
Officer:
2nd Bank Name:
2nd Bank Address:
Phone:
Acct#:
Officer:
Equipment:

Your cooperation to fully complete this application will expedite approval of your lease.

By submitting this form, I authorize you to obtain such information as you may require concerning the statements contained in this application, including TRW reports on individuals listed above, and agree that the application shall remain your property, whether or not the lease is granted. I hereby verify all statements cotained in this application are true and complete, and are made for the purpose of obtaining credit.
Name:
Today's Date:

My Date of Birth: