Lease Application Customer: Legal Name Contact Name Phone No. Trade Name (if applicable) Fax No. Business Address City State Zip Code Email Address Type of BusinessSelect Type of BusinessProprietorshipCorporationGeneral PartnershipLimited PartnershipLimited Liability CompanyState or Local Government Years Company In Business Tax Identification No. Principal #1: Name and Title Home Address City State Zip Code % of Ownership Social Security No. US Citizen?Select CitizenYesNo Home Phone No. Principal #2: Name and Title Home Address City State Zip Code % of Ownership Social Security No. US Citizen?Select CitizenYesNo Home Phone No. Equipment Supplier: Business Name Contact Name Phone No. Business Address City State Zip Code Email Address Fax No. Equipment: Equipment Locationcheck if same as Lessee’s address Credit Requested $ Quantity Make and Model General Descriptioncheck 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 Cost       References: 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 Signature Date Printed Name Signature Date