Equipment Leasing New & Used

Equipment Leasing (New & Used) Application

This form is also available as a download which can be faxed to 336-217-8155.
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Increase Cash Flow

Conserve Working Capital

Maintain Liquidity

Preserve Borrowing Capacity

Equipment Leasing (A, B, C, & D Rates)
Loan Originator / Broker:
Contact:
Comment:
Address:
Phone:
Fax:
Equipment Description:
Equipment Cost:
Term:
Equipment Location:

Lessee:
Phone:
Fax:
Address:
Type of Business:
Sole Proprietorship:
Partnership:
Corporation:
Public / Private:

Principal's Name:
Title:
SSN:
Home Address:
Principal's Name:
Title:
SSN:
Home Address:

Bank:
Account #:
Type:
Phone:
Fax:
Contact:

Bank:
Account#:
Type:
Phone:
Fax:
Contact:

Trade Ref. 1
Contact:
Phone:

Trade Ref. 2
Contact:
Phone:

Trade Ref. 3
Contact:
Phone:

Vendor:
Contact:
Phone:
Fax:
Address:

I authorize you to obtain such information as you may require concerning the statements contained in this application, and agree that the application shall remain your property, whether or not the lease is granted. I hereby certify that all statements contained in this application are true and complete and are made for the purpose of obtaining credit. I agree to notify you of any material changes in the condition of affairs, and this statement shall be construed by you to be a continuing statement of the conditions of the Lessee until written notice to the contrary is received by you. Lessee and its principal authorize the release of credit information to the Lessor.