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   EQUIPMENT LEASE APPLICATION
Lease Line: 832-797-8158 Fax Line: 832-446-6506
 
VENDOR INFORMATION
Vendor Name:
Vendor Code:
Address:
City:
State:
Zip:
Tel no:
Fax no:
Contact:
 
EQUIPMENT INFORMATION
Description:
Equip. Cost



Lease Term:
Buyout:

 
LESSEE INFORMATION
Full Legal Name:
DBA:
Address:
City:
State:
Zip:
Years In Bus:
No. of Employees:
Contact Person:
Title:
Nature of Business:
Tel no:
Fax no:
Business Type:

Tax ID#
 
PERSONAL INFORMATION
Officer:
Social Security #:
Title:

Address:
City:
Zip:
E-mail
Home Tel :
 
TRADE REFERENCES
Name:
Telephone #:
Contact:
 
TRADE REFERENCES
Name:
Telephone #:
Contact:
 
TRADE REFERENCES
Name:
Telephone #:
Contact:
 
BANK INFORMATION
(Two Year History)
Bank Name:
Checking Savings Loan
Contact:
Telephone:
Contact Name:
Acct. #:
 
By signing below, each undersigned individuals(s), who either a principle of the credit applicant listed below, or a personal guarantor of its obligations, provides written instruction to Lease One or its designee (and any assignee or potential assignee thereof) authorizing review of his or her personal credit profile from a national credit bureau. Such authorization shall extend to obtaining a credit profile in considering the application of the credit applicant and subsequently for the purposes of update renewal, or extension of such credit and for reviewing or collecting the resulting account. A photocopy or facsimile copy of this authorization shall be as a valid original. In addition to authorizing review of my/our credit profile from any national credit bureau the undersigned also authorizes my/our financial institutions and creditors to release credit information required by Lease One or its designee (and any assignee or potential assignee thereof.
 
DATE:
 
SIGNATURE TITLE:
 
DATE SIGNATURE TITLE:
 
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