Fillable Lease Source Financial Solutions - Application Form

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Lease Source Financial Solutions - Application Form

On average this form takes 14 minutes to complete

The Lease Source Financial Solutions - Application Form form is 1 page long and contains:

  • 2 signatures
  • 4 check-boxes
  • 45 other fields

Country of origin: US
File type: PDF

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www.LeaseSource.Net
© 1993
Phone: 800-813-0725 Fax: 888-813-2789
Email Contact: info@LeaseSource.Net
SELLER: _________________________________________
CONTACT:_________________________________
PHONE: _________________________
EMAIL: _________________________
Scan/Email to info@leasesource.net or fax to: 888-813-2789
1. Corporate or Business Name
DBA Name
YOUR WEBSITE:
Address
City
County
State
Zip
Phone
FAX
email
2. Equipment Location: Same
Other
3. Type of Business
Years in Business
Term requested (2,3,4,5 yrs
)
4. Principals: President, Owners, Partners, Members
Full Name
Social Security
Home Address & Zip
Title and %
ownership
Fed Tax ID #
Proprietorship
Partnership
Corporation
LLC
5. Basic Description of Equipment
Approximate Equipment Cost: $ New
Used
6. Lessee's Bank & Branch
Contact
City & State
Years @ bank
Phone
Acct. #
Please include copy of equipment quote and the summary page of the last 3 bank statements
By signing below, the undersigned individual as principal of and/or guarantor for the applicant, authorizes broker or their assign,
(Broker/Lessor/Debtor), its designee, assigns or potential assigns, to review his/her personal credit profile provided by national credit bureaus in
considering this Application and for the purpose of the update, renewal, or extension of credit to the Applicant or the collection of any resultant
accounts. A fax or photocopy of this authorization shall be valid as the original.
Signature Date
Signature Date
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Lease Source Financial Solutions - Application Form

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Completed 24 May 2020

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