applyforlease.com

LEASE APPLICATION

Red denotes required information.

LESSEE INFORMATION

Company: (Legal Name)
Contact:
Address:
Address2:
City, State, Zip:	,
Phone:
FAX:
Years in Bus:
Business Type:
Federal Tax Id:

EQUIPMENT INFORMATION

Equipment Cost:
Type of Equipment:
Equip Manufacturer:
Equipment Address: (if different)
City, State, Zip:	,

VENDOR INFORMATION

Vendor:

LEASE TERMS

Rental Term:
Buy-Out:

PERSONAL DATA

Primary Principal:
Address:
City, State, Zip:	,
Date of Birth: (mm/dd/yy)
Percent Ownership:
Title:
Phone:
FAX:

Principal II:
Address:
City, State, Zip:	,
Date of Birth: (mm/dd/yy)
Percent Ownership:
Title:
Phone:
FAX:

BANK REFERENCES

Bank Name:
Contact:
Phone:
Account Number:

LEASE/LOAN REFERENCES

Trade Reference:
Phone:
Account Number:
Contact: