Sewing Machine Resources - Sewing Mall

 

Equipment Leasing Application

Business Name

Address

City

State

Zip

Phone Number

Fax Number

E-Mail

Federal ID#

Date Established

Type of Business

Date Incorporated

Business Type

Muni Type

Principal or Officer

Title

Social Security Number

Home Address

City

State

Zip

Phone

Principal or Officer #2

Title

Social Security Number

Home Address

City

State

Zip

Phone

Bank Reference

Name of Bank

Bank Officer

City

State

Account Number

Phone Number

Name of Bank #2

Bank Officer

City

State

Account Number

Phone Number

Trade Reference

Name of Business

Contact Name

City

State

Phone Number

Name of Business #2

Contact Name

City

State

Phone Number

Name of Business #3

Contact Name

City

State

Phone Number

Equipment Description

Equipment Cost

Tax

Total

Term

Rate

Lease Payment

Advance Payment
Security Deposit

Buyout

Location of Equipment

Vendor

Address

Contact Person

Phone Number

I/WE HEREBY AUTHORIZE YOU TO WHOM THIS APPLICATION IS MADE, OR YOUR AGENTS, TO INVESTIGATE MY/OUR CREDIT WORTHINESS AND WILL PROVIDE FINANCIAL STATEMENTS, TAX RETURNS, ETC., AS YOU DEEM NECESSARY. BY THE EXECUTION OF THE LEASE AGREEMENT, I/WE WARRANT THAT THE INFORMATION SUBMITTED HEREIN IS TRUE AND CORRECT AND HEREBY AUTHORIZE REFERENCES CONTAINED HEREIN TO RELEASE ANY NECESSARY INFORMATION VIA PHONE OR BY FAX. FURTHER, I/WE WILL INDEMNIFY LESSOR FOR ANY AND ALL COSTS INCURRED WITH THIS APPLICATION FOR CREDIT INCLUDING ANY COSTS INCURRED IN THE PLACEMENT OR RESERVATION OF THE INTENDED LEASED EQUIPMENT BASED ON THE INFORMATION CONTAINED HEREIN.

Signature

Date

Notice: The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national origin, sex, marital status, or age (provided the applicant has the capacity to enter into a binding contract); or because all or part of the applicant's income derives from any public assistance program or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act. The federal agency that administers compliance with this law concerning this creditor is the Federal Trade Commission, Equal Credit Opportunity, Washington, D.C., 20580.

 

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