Equipment leasing application form


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Business
Business Name
Phone		Fax:
Email		Website:
Address	(Street)
City		State Zip

Business Type		Number of Employees
Est. Annual Sales		Net Worth
Years In Business

Ownership
Business Structure	Proprietorship Partnership Corporation
Fed. Tax No.

First Principal
Name		Title
Soc. Sec. No.		% Owner
Home Phone#
Home Address	(Street)
City		State Zip
Second Principal
Name		Title
Soc. Sec. No.		% Owner
Home Phone#
Home Address	(Street)
City		State Zip

Equipment
Vendor		Phone
Contact
Equipment New Used Reconditioned
Manufacturer and Model
Sale Price
Lease Term 12 24 36 48 60 Other /No. of Months:
Preferred Buyout $1.00 10%
I hereby authorize Advantage Leasing Corporation or any credit bureau or other investigative agency employed by Advantage Leasing Corporation to investigate the references herein listed or statements or other data obtained from me or from any other person pertaining to my credit and financial responsibility.